Rapid in vitro evaluation of hemodynamic performances of customized handmade trileaflet‐valved conduits using Duffing–Holmes‐based self‐synchronization dynamic errors

Abstract

Abstract Valvular heart diseases or chronic valvular dysfunctions are widely treated by percutaneous pulmonary valve implantation (PPVI) in cases requiring prosthetic pulmonary valve implantation and replacement. Commercial pulmonary valve stents (CPVS), sucas Epic™ valved stents or mechanical heart valves, are available to improve narrowed pulmonary valves or address problems of blood flow regurgitation in the right ventricle to pulmonary artery conduit. However, these commercial valve stents have limited availability of different sizes and diameters. Currently, the customized handmade trileaflet‐valved conduit (HTVC) is a novel surgical strategy being used in young adults and children. The HTVC can be designed witdifferent optimal parameters and can be reconstructed as expanded polytetrafluoroethylene (ePTFE)‐valved conduits for PPVI clinical applications. To verify the availability and durability of the HTVC, we validated its hemodynamic and functional performances using a mock circulation system in an in vitro study. At different heart rates and blood flows, we used the forward stroke flow (systolic period) and regurgitation flow (diastolic period) to calculate the pulmonary regurgitation fraction (RF) and ejection efficiency (EE) to evaluate the HTVC performances. We also observed its dynamic behaviours using an endoscopic camera in a pulsatile experimental setting. In addition, we used a Duffing–Holmes‐based chaotic synchronization system to track the trajectories of pulmonary artery pressure waveforms of the HTVC and CPVS, whiccan synchronously obtain the dynamic self‐synchronization errors for quantifying the HTVC's performance. Througin vitro laboratory experiments, the comprehensive dynamic errors were found to be positively correlated witthe RFs and EEs. The experimental results indicate that the results obtained by the HTVC are promising, including a decrease in the RF and an increase in the EE, as compared witCPVSs. Therefore, the dynamic errors can be used to obtain rapid quantitative indications of the performance quality of HTVCs under different hemodynamic conditions for RV‐PA reconstruction.