NORRED EXHIBIT 2132 - Page 1
`Medtronic, Inc., Medtronic Vascular, Inc.,
`& Medtronic Corevalve, LLC
`v. Troy R. Norred, M.D.
`Case IPR2014-00111
`
`

`

`//-.J
`
`[Wax fad/”flail
`
`119(4 Pt 1):?53-63,
`
`Grande-Allen KJ. Cochran RP. Reinhall PG. Kunzelman KS.
`Institution
`Department of Biomedical Engineering, Cleveland Clinic Foundation,
`Cleveland. OH. USA.
`Title
`Re—creation of sinuses is important for sparing the aortic valve: a
`finite element study.
`Source
`Journal of Thoracic 0 Cardiovascular Surgery.
`2000 Apr.
`Local Messages
`Owned by MU HSL
`Abstract
`OBJECTIVE: The treatment of choice for aortic valve insufficiency due
`to root dilatation has become root replacement with aortic valve
`sparing. However, root replacement with a synthetic graft may result in
`altered valve stresses. The purpose of this study was to compare the
`stress/strain patterns in the spared aortic valve in different root
`replacement procedures by means of finite element modeling. METHODS: Our
`finite element model of the normal human root and valve was modified to
`simulate and evaluate three surgical techniques:
`(1) "cylindrical" graft
`sutured below the valve at the anulus,
`(2) "tailored" graft sutured just
`above the valve. and {3} "pseudosinus" graft.
`tailored and sutured below
`the valve at the anulus. Simulated diastolic pressures were applied, and
`stresses and strains were calculated for the valve, root, and graft.
`Leaflet coaptation was also quantified. RESULTS: All three root
`replacement models demonstrated significantly altered leaflet stress
`patter!
`me as compared with normal patterns. The cylindrical model showed the
`greatest increases in stress {16%-l73%} and strain {10%—98%J.
`followed
`by the tailored model [stress +10%-157%, strain +9%—36%}. The
`pseudosinus model showed the smallest increase in stress [9%-28%) and
`'
`strain (Eh-31%), and leaflet coaptation was closest to normal.
`qfififlflfl§:g§) Valve—sparing techniques that allow the potential for sinus
`space fo
`ation (tailored, pseudosinus) result in simulated leaflet
`stresses that are closer to normal than the cylindrical technique.
`Normalized leaflet stresses in the clinical setting may result in
`improved longevity of the spared valve.
`
`,
`
`”
`
`n
`
`\DS/l‘
`
`Citation <9)
`
`I.
`
`PubMed Identifier
`
`Institution
`
`fl/j/Z/ég/
`Unégesgggntifier
`10703772
`AuthorsCacciola G. Peters GW. Schreurs PJ.
`(£4,
`Department of Mechanical Engineering. Eindhoven University of
`Technology. P.0. Box 513, 5600 MB Eindhoven. The Netherlands.
`giovannanfw.wtb.tue.nl
`Title
`A three-dimensional mechanical analysis of a stentless fibre—
`
`//
`
`l
`
`\S\
`’70
`\9
`
`I
`(6/?
`\\\\EE%//
`V
`Q
`
`{
`
`Source
`Journal of Biomechanics.
`
`33(5}:521-30, 2000 May.
`
`Abstract
`Failure of bioprosthetic and synthetic three-leaflet valves has been
`
`~{fi7
`reinforced aortic valve prosthesis.
`(2
`Local Messages
`fat
`MU HSL owns some issues. Check Library Catalog Holdings.
`
`shown to occur as a consequence of high tensile and bending stresses, (gag
`
`NORRED EXHIBIT 2132 - Page 2
`NORRED EXHIBIT 2132 - Page 2
`
`

`

`4
`
`.«
`
`7/ch 2/ Wdflf“
`
`in the
`Moreover,
`acting on the leaflets during opening and closi
`stented prostheses, whether synthetic or biological,
`the absence of
`
`
`ontraction of the aortic base, due to the rigid stent, ca
` ea ets to be subjected o n on hysiolog ca , which
`
`
`
`an ,
`ica ion. It is s own
`o ca c
`is re
`r ic base and leaflet attachment, and leaflet
`as
`'
`'
`fibre-reinforcement result in reduced stresses in the weaker parts of
`the leaflets in their closed configuration. It is postulated that this
`leads to a decrease of tears and perforations, which may result in a
`improved long-term behaviour. The effect of a flexible leaflet
`attachment and aortic base of a synthetic valve is investigated with a
`finite element model. Different fibre-reinforced structures are analysed
`with respect to!
`the stresses that are likely to contribute to the failure of fibre-
`reinforced prostheses and compared with the results obtained for a
`stented prosthesis. Results show that for the stentless models a
`reduction of stresses up to 75% is obtained with respect to stented
`models with the same type of reinforcement.
`
`Citation <10)
`Unique Identifier
`201é0328
`PubMed Identifier
`106?7158
`Authors
`
`Morsi YS.
`Sakhaeimanesh A. Clayton BR.
`-
`Institution
`Centre for Research and Technology Development, School of Engineering
`and Science, Swinburne University of Technology, Hawthorn, Victoria,
`Australia. ymorsi@swin.edu.au
`Title
`
`C:
`x)
`{4/
`
`Hydrodynamic evaluation of three artificial aortic valve chambers.
`Source
`
`Artificial Organs.
`Local Messages
`Owned by MU HSL
`Abstract
`
`24(1):57-63, 2000 Jan.
`
`The effect of chamber geometry on the characteristics of turbulent
`steady flow through a newly designed artificial heart valve, "the
`jellyfish valve," has been investigated for flow rates matching those of
`peak systole. Laser DOPpler Anemometry {LDA} was employed to determine
`the velocity and shear stress distributions at various locations
`downstream of the jellyfish valve. Three geometrically different aortic
`valve chambers have been investigated: namely,
`a chamber with sinuses of
`Valsalva, an ellipsoidal chamber, and a cylindrical chamber. The results
`of this investigation indicated that the aorta with sinuses of Valsalva
`model had the highest turbulent shear stresses whereas the ellipsoidal
`model gave the highest-pressure drops. However,
`for the various flow
`rates examined,
`including the systole peak value of 26 L/min, it appears
`that the ellipsoidal model displays better hydrodynamic characteristics
`in terms of shear stress and uniformity of axial velocity distributions
`
`downstream of the jellyfish valve.
`
`Siggégzgggiéifier
`
`PubMed Identifier
`10509186
`
`Wfl fl /Zfl(d// fl/ .//
`
`
`
`NORRED EXHIBIT 2132 - Page 3
`NORRED EXHIBIT 2132 - Page 3
`
`

`

`
`
`A...
`
`_._.-._—
`
`
`
`Authors
`
`Sung HW. Chang Y. Chiu CT.
`Institution
`
`I.
`
`7/49 )[ W4 wra/
`
`Chen CN.
`
`Liang HC.
`
`Department of Chemical Engineering, National Central University,
`Chung-Li, Taiwan, ROC. hwsungecc.ncu.edu.tw
`Title
`
`Mechanical properties of a porcine aortic valve fixed with a naturally
`occurring crosslinking agent.
`Source
`
`Biomaterials.
`Local Messages
`MU HSL owns some issues. Check Library Catalog holdings.
`Abstract
`
`20(19}:1759—72, 1999 Oct.
`
`ic
`'
`f
`The study investigates the mechanical properties
`valve leaflets fixed with a naturally occurrin crosslinking agent,
`
`fiat distinct pressure heads. Fresh andW ed
`
`coun -
`
`-
`
`the changes
`to fixation,
`arts were used as controls. Subsequent
`in leaflet collagen crimps and its surface morphology were investigated
`by light microscopy and scanning electron microscopy {SEM}. Also,
`the
`crosslinking characteristics of each studied group were determined by
`measuring its fixation index and denaturation temperature.
`In the
`mechanical testing,
`tissue strips made from each studied group were
`examined in both the circumferential and radial directions. Histological
`and SEM comparisons between fresh porcine aortic valve leaflet and those
`fixed at medium or high pressure revealed that the following changes may
`occur: elimination of the natural collagen crimping, and extensive loss
`of the endothelial layer. The denaturation temperatures of the
`glutaralde!
`hyde-fixed leaflets were significantly greater than the genipin-fixed
`leaflets; however,
`their fixation indices were comparable. Generally,
`fixation pressure did not affect the crosslinking characteristics of the
`genipin- and glutaraldehyde-fixed leaflets. It was found that fixation
`of porcine aortic valves in genipin or glutaraldehyde did not alter the
`mechanical anisotropy observed in fresh valve leaflets. This indicated
`that the intramolecular and intermolecular crosslinks introduced into
`the collagen fibrils during fixation is of secondary importance to the
`presence of structural and mechanical anisotropy in fresh leaflet.
`Tissue
`ixa ion in genipi
`e y e may pro uce disEIECt
`crosslinking structures. However,
`the difference in crosslinking
`structure between the genipin- and glutaraldehyde-fixed leaflets did not
`seem to cause any significant discrepancies in their mechanical
`properties when compared at the same fixation pressure. Nevertheless,
`regardless of the !
`crosslinking agent used, changes in mechanical properties and ruptured
`patterns were observed when the valve leaflets were fixed at distinct
`pressures.
`
`Siiéfii°ldéiiimr %fl 79 C fl/fl/
`
`99396317
`PubMed Identifier
`10468241
`Authors
`
`a //
`
`gl/
`
`\Zt
`
`LaBorde DV. Yoganathan AP.
`
`Weston MW.
`Institution
`Institute of Bioengineering and Bioscience, School of Biomedical,
`$n91neering, Georgia Institute of Technology Atlanta 30332-0535, USA.
`'
`~
`'on o
`t e s ear stress -
`the surface of an aortic valve
`leaflet.
`
`'
`/Z;Lz7/?&Z/{$:
`
`" gxdea/zca/ £5 1"”
`395; _?fi / ( d%/)
`3’,:?)2?:j /€7 a???
`
`72/- We:
`NORRED EXHIBIT 2132 - Page 4
`NORRED EXHIBIT 2132 - Page 4
`
`

`

` Authors
`
`"
`
`7&9 )g W4 W/(f’a/
`
`Sung RN. Chang Y. Chiu CT. Chen CN.
`Institution
`
`Liang HC.
`
`Department of Chemical Engineering, National Central University,
`Chung—Li, Taiwan, ROC. hwsung@cc.ncu.edu.tw
`Title
`
`Mechanical properties of a porcine aortic valve fixed with a nature 1
`occurring crosslinking agent.
`Source
`Biomaterials.
`Local Messages
`MU HSL owns some issues. Check Library Catalog Holdings.
`Abstract
`
`-20{19}:l?59-?2, 1999 Oct.
`
`_
`
`L/
`
`L
`
`ic
`‘
`The study investigates the mechanical properties
`valve leaflets fixed with a naturally occurrin crosslinkin agent,
`
`”at distinct pressure heads. Fresh andfilmwmw ed
`
`coun'~ -
`
`the changes
`to fixation,
`arts were used as controls. Subsequent
`in leaflet collagen crimps and its surface morphology were investigated
`by light microscopy and scanning electron microscopy (SEM). Also,
`the
`crosslinking characteristics of each studied group were determined by
`measuring its fixation index and denaturation temperature.
`In the
`mechanical testing,
`tissue strips made from each studied group were
`examined in both the circumferential and radial directions. Histological
`and SEM comparisons between fresh porcine aortic valve leaflet and those
`fixed at medium or high pressure revealed that the following changes may
`occur: elimination of the natural collagen crimping, and extensive loss
`of the endothelial layer. The denaturation temperatures of the
`glutaralde!
`hyde-fixed leaflets were significantly greater than the genipin—fixed
`leaflets; however,
`their fixation indices were comparable. Generally,
`fixation pressure did not affect the crosslinking characteristics of the
`genipin- and glutaraldehyde—fixed leaflets. It was found that fixation
`of porcine aortic valves in genipin or glutaraldehyde did not alter the
`mechanical anisotropy observed in fresh valve leaflets. This indicated
`that the intramolecular and intermolecular crosslinks introduced into
`the collagen fibrils during fixation is of secondary importance to the
`pregence of structural and mechanical anisotropy in fresh leaflet.
`Tissue
`ixa ion in genipi
`a
`e y e may pro uce distifict
`crosslinking structures. However,
`the difference in crosslinking
`structure between the genipin— and glutaraldehyde—fixed leaflets did not
`seem to cause any significant discrepancies in their mechanical
`properties when compared at the same fixation pressure. Nevertheless,
`regardless of the E
`crosslinking agent used, changes in mechanical properties and ruptured
`patterns were observed when the valve leaflets were fixed at distinct
`pressures.
`
`Siiéfiildéiiifie %fl 79 C 7/
`
`99396317
`PubHed Identifier
`10468241
`Authors
`
`5/ //
`
`4...-
`
`LaBorde DV. Yoganathan AP.
`
`Heston MW.
`Institution
`Institute of Bioengineering and Bioscience, School of Biomedical,
`$n9ineering, Georgia Institute of Technology Atlanta 30332—0535, USA.
`.
`"
`h-
`'on o
`t e s ear stress .
`the surface of an aortic valve
`leaflet.
`
`NORRED EXHIBIT 2132 - Page 5
`NORRED EXHIBIT 2132 - Page 5
`
`

`

`2r,”
`
`7729y We:r/m/
`
`2625} and Ionescu-Shiley standard pericardial valves were designed prior
`to 1975, while the Medtronic—Hall tilting disc, St. Jude Medical
`bileaflet, Hancock porcine (model 2501, Hancock II porcine {model 410],
`Carpentier—Edwards porcine (model 2650] and Carpentier-Edwards
`pericardial {model 2900} valves were designed after 1975. The pressure
`dro!
`
`performance indices of 0.30 to 0.45, whereas the valves designed after
`1975 had performance indices of 0.40 to 0.?0. The regurgitant volumes
`were higher for the mechanical designs (5.0 to 11.0 cm3/beat} compared
`to the tissue bioprostheses [1.0 to 5.0 cm3/best). Two—dimensional laser
`Doppler anemometry studies indicated that the valves designed after 1975
`tended to create more centralized flow fields, with reduced levels of
`turbulent shear stresses. However, none of the current valve designs is
`ideal:
`they all create areas of stasis and/or regions of low velocity
`reverse flow; and regions of elevated turbulent shear stresses that are
`capable of causing sub—lethal and/or lethal damage to the formed
`elements of blood.
`
`Citation (63>
`Unique Identifier
`88243853
`PubMed Identifier
`2967827
`Authors
`
`,
`
`”
`
`U‘\
`
`Hasenkam JM. Westphal D. Nygaard H. Reul H. Giersiepen M.
`Stodkilde-Jorgensen H.
`Institution
`Department of Thoracic and Cardiovascular Surgery, Aarhus
`Kommunehospital, Denmark.
`Title
`
`‘
`\J/)
`
`J
`
`In vitro stress measurements in the vicinity of six mechanical aortic
`valves using hot-film anemometry in steady flow.
`Source
`
`Journal of Biomechanics.
`Local Messages
`MU HSL owns some issues. Check Library Catalog Holdings.
`Abstract
`
`21(3):235-47, 1988.
`
`Based on hot-film anemometry, point velocity measurements in the total
`cross sectional area 1 and 2 diameters downstream of: Bjork-Shiley
`Standard, Convex-Concave and Monostrut, Hall-Kaster
`(Medtronic-Hall),
`St. Jude Medical and Starr-Edwards Silastic Ball aortic valves were
`made. The spatial distribution of Reynolds Normal Stresses {RNS} was
`visualized three—dimensionally in order to point out where and to what
`extent the highest RNSs were found. The measurements were made in steady
`flowing glycerol mixture at flow rates 10, 20 and 30 l. min-1
`corresponding to mean velocities of 27, 54 and 81 on 5-1. The highest
`maximum RNS values were around 250 Nm-Z and were found downstream of the
`Bjork—Shiley Monostrut and Starr—Edwards Ball valves. The lowest maximum
`RNSs were found downstream of the St. Jude Medical and Hall—Raster
`(Medtronic-Hall) valves [125-140 Nm-2). The Starr—Edwards valve had the
`highest mean ENS {11? Nm-Z)
`followed by the Bjork-Shiley Monostrut
`(B?
`Nm-Z}. These!
`simplified measurements of artificial heart valve performances
`concerning RNS, enhance the interpretation of results in more
`complicated flow models not to say in vivo.
`
`Enigfiioxidzggifier %/ /fl€fl/j/ f L‘///
`
`",7
`
`NORRED EXHIBIT 2132 - Page 6
`NORRED EXHIBIT 2132 - Page 6
`
`
`

`

`/.. L, fi
`
`77 d/ Wa wrap!
`
`Leeds polyurethane trileaflet heart valve in a simula ed pulsatile flow
`regime using laser Doppler velocimetry. The main difference between the
`two valves studied was the manufacturing method used to create the
`valves. The filmflfabricated valve was constructed from solvent-cast
`sheets of polyurethane,
`thermally formed into the correct leaflet
`geometry. The dip-cast valve used a stainless steel mould which was
`dipped into a polyurethane solution to produce the valve leaflets.
`Significant differences were visible between the fully open leaflet
`shape of each valve. The distribution of mean axial velocity and
`Reynolds normal stress {RNSJ was shown to be dependent on the shape of
`the fully open valve orifice. For the film-fabricated valves,
`flow
`recirculation and high values of RNS were present downstream of the
`frame posts. The maximum value of RNS obtained downstream of the film—
`fabricated valve at peak syst!
`ole was 14? N/mZ. Results for the dip-cast valve showed a more uniform
`distribution of mean axial velocity and RNS resulting from the more
`circular central orifice produced by the dip—cast leaflets. The maximum
`value of ENS obtained downstream of the dip-cast valve at peak systole
`was 109 N/m2. These results demonstrate the effect of the open valve
`geometry on the flow characteristics downstream of trileaflet valves and
`that minor changes to the open leaflet geometry can significantly affect
`the flow characteristics and the possibility of flow-related blood
`damage occurring in vivo.
`
`Citation <28)
`.
`_
`Unggtluleléglgntifier W” zzfl Cflf/ ‘/
`
`PubMed Identifier
`3953434
`Authors
`
`l/jéf;:> {ijij/J
`_/
`.
`
`Hasenkam JM. Nygaard H. Terp K. Riis C. Paulsen PK.
`Institution
`
`-
`
`\L///
`
`Aarhus University Hospital, Denmark.
`Title
`
`Hemodynamic evaluation of a new bileaflet valve prosthesis: a
`animal experimental study.
`[see comments].
`Comments
`
`a ute
`
`Department of Cardiothoracic and Vascular Surgery, Skejby Sygehus,
`
`
`Comment in: J Heart Valve Dis. 1996 Nov;5(6):5?2-3
`Source
`'
`
`Journal of Heart valve Disease.
`Local Messages
`MU HSL owns some issues. Check Library Catalog Holdings.
`Abstract
`
`5(6}:574-80, 1996 Nov.
`
`BACKGROUND AND AIMS OF THE STUDY: A newly developed heart valve
`(Medtronic Parallel} was tested in an acute animal experimental model.
`METHODS: Five prototype valves were implanted in the aortic position in
`seven 90 kg pigs to enable acute evaluation of the hemodynamic
`performance in terms of turbulent stresses and transvalvular pressure
`drop. Turbulent stresses in the ascending aorta were measured using a 10
`MHZ perivascular Doppler echocardiographic transducer designed to
`measure the radical velocity component at 17 different points covering
`the aortic cross—sectional area. RESULTS: The drop in transvalvular peak
`pressure measured with fluid—filled catheters showed a non-linear
`
`relationship with cardiac output and was always < 12 mmHg. The Reynolds
`normal stresses were < 60 N/m2 in systole within 50 ms
`time windows,
`which is insufficient to cause mechanical damage of the formed elements
`of the blood. CONCLUSIONS: From a hemodynamic point of view the
`performance of the Medt!
`
`ronic Parallel aortic valve is fully acceptable and within the range of
`
`NORRED EXHIBIT 2132 - Page 7
`NORRED EXHIBIT 2132 - Page 7
`
`
`
`

`

`1 --
`
`1’1— -' 7’0/ ”5! fi/MC/
`
`humans.
`
`7(2):180-9, 1998 Mar.
`
`Journal of Heart Valve Disease.
`Local Messages
`MU HSL owns some issues. Check Library Catalog Holdings.
`Abstract
`BACKGROUND AND AIMS OF THE STUDY: Pericarbon is a new—generation
`bovine pericardial bioprosthesis designed to withstand mechanical wear.
`Following optimal
`in vitro testing and animal experiments, clinical
`trials were initiated in many EurOpean centers and explants sent to our
`department for pathological evaluation. This included gross,
`radiographic, histologic and ultrastructural investigations. METHODS:
`Between 1986 and 1996, 24 bioprostheses (eight aortic,
`ll mitral,
`two
`mitro-aortic, one tricuspid) were collected from 22 patients [10 males
`and 12 females; mean age 57.0 +/— 18.9 years} either at autopsy (nine)
`or reoperation [15}. RESULTS: Ten bioprostheses explanted < 2 months
`after surgery were either normal or failed because of surgical problems
`or non-structural causes. Among the other 14 bioprostheses {mean
`placement 41.9 +/- 23.6 months; range:
`7
`to 90 months}, structural
`deterioration occurred in seven and was due to dystrophic calcification
`with stenosis in five (t!
`hree aortic,
`two mitral}, mixed lesion in one (mitral), and incompetence
`in one by calcium-related commissural tear {mitrél}. At
`the
`ultrastructural level, calcification was detected either on cell debris
`or upon collagen fibers. No bioprosthesis failed because of fibrous
`tissue overgrowth. Of the remaining seven bioprostheses, vegetative
`endocarditis occurred in two,
`thrombosis in one, and aseptic
`paravalvular leak in one: whereas three showed no signs of dysfunction.
`CONCLUSIONS: This pathologic experience with the Pericarbon valve showed
`calcification to be the main cause of late structural failure, causing
`mainly cusp stiffness and bioProsthesis stenosis. Tissue rupture or
`abrupt dysfunction never occurred. Thus, prevention of mineralization
`remains the main challenge.
`
`Citation <25>
`
`9450254
`
`( \/
`
`,-t—a
`kw.)
`
`_
`
`Di Martino E.
`
`Gamba A.
`
`Procopio AM.
`
`Fumero R.
`
`mkqv
`
`~
`
`3
`1;
`
`‘£<£
`
`Unique Identifier
`98111924
`PubHed Identifier
`Authors
`Redaelli A.
`Institution
`Department of Bioengineering, Politecnico di Milano, Italy. Q0
`redaelliflcebitec.hsr.it
`Title
`Assessment of the influence of the compliant aortic root on aortic
`Medical Engineering 5 Physics.
`19(8}:696-710, 199? Dec.
`
`valve mechanics by means of a geometrical model.
`Source
`
`Abstract
`
`In recent years several researchers have suggested that the changes in
`the geometry and angular dimensions of the aortic root which occur
`during the cardiac cycle are functional to the optimisation of aortic
`valve function, both in terms of diminishing leaflet stresses and of
`
`fluid-dynamic behaviour. The paper presents an analytical parametric
`model of the aortic valve which includes the aortic root movement. The S?
`indexes used to evaluate the valve behaviour are the circumferential
`membrane stress and the stress at the free edge of the leaflet,
`the
`index of bending strain,
`the bending of the leaflet at the line
`attachment in the radial and circumferential directions and the shape of
`
`\ ?
`
`C1%{;
`flak
`
`£7?
`
`-
`
`\
`‘\
`
`0)
`
`Lit
`
`NORRED EXHIBIT 2132 - Page 8
`NORRED EXHIBIT 2132 - Page 8
`
`
`

`

`// 4,4,3" fl fl/ Mfl/a/LV
`
`98364269
`PubMed Identifier
`9699113
`Authors
`Kolev N.
`Title
`
`Left ventricular end-systolic wall stress and left ventricular
`ejection time revisited. [letter; comment}.
`Comments
`
`Comment on: Eur J Anaesthesiol. 1997 Nov;14(6]:558—65
`Source
`European Journal of Anaesthesiology.
`Local Messages
`Ouned by MU HSL
`
`15(4}:509-11. 1998 Jul.
`
`Citation (20>
`
`Unique Identifier
`
`99281690
`PubMed Identifier
`10355559
`Authors
`Maymir JC. Deutsch S. Meyer RS. Geselowitz 03. Tarbell JM.
`Institution
`The Bioengineering Program, The Pennsylvania State University,
`University Park, USA.
`Title
`Mean velocity and Reynolds stress measurements in the regurgitant jets
`of tilting disk heart valves in an artificial heart environment.
`Source
`
`(h/I/r
`
`Annals of Biomedical Engineering.
`Local Messages
`MU HSL owns some issues. Check Library Catalog Holdings.
`Abstract
`Laser Doppler velocimetry, with a high temporal resolution (1 ms time
`windows), was used to measure the flow field in two regions {major and
`minor orifices] near the aortic and mitral valves (Bjork Shiley
`monostrut Nos. 25 and 27, respectively) of the Penn State artificial
`
`26(1}:146—56, 1998 Jan—Feb.
`
`Maximum Reynolds shear stresses of approximately 20,000 dyn/cmz and
`time-averaged Reynolds shear stresses of approximately 2000 dyn/cmZ were
`observed during the regurgitant
`f10w phase. These elevated Reynolds
`shear stresses suggest that regurgitant jets play a role in the
`
`Citation (21>
`Unique Identifier
`98394326
`PubMed Identifier
`9727343
`Authors
`Krafczyk M. Cerrolaza M.
`Institution
`Lehrstuhl fur Bauinformatik. Civil Engineering Department, Munich.
`Germany. krafteserver.inf.bauwesen.tu-muenchen.de
`
`Schulz M. Rank E.
`
`Wfld 7% Cd//
`
`/7.///
`
`
`
`1
`
`4
`
`.
`
`I
`
`NORRED EXHIBIT 2132 - Page 9
`NORRED EXHIBIT 2132 - Page 9
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`
`

`

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`
`Borrower: MOUMCO
`
`Lending String:
`
`Patron:m
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`Artlcle Title: On the monodimensional approach
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`Article Title: A three-dimensional mechanical
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`Journal Title: Journal of biomechanics.
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`Volume: 31 Issue: _2
`Monlhflear: 1998 FebPages: 115-23
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`NORRED EXHIBIT 2132 - Page 15
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