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Schematic of a bileaflet mechanical heart valve implanted in the aortic position during the leakage flow phase. Shown are the blood cells damaged from the high shear environment experienced within the leakage gaps (not to scale). Top panel: forward flow phase; bottom panel: leakage flow phase. Grey arrows, leakage flow; red arrows, bulk flow direction; Ao, aorta; LV, left ventricle.
