Invited Lecture A Review of Cavitation Uses and Problems in Medicine

There are an increasing number of biological and bioengineering contexts in which cavitation is either utilized to create some desired effect or occurs as a byproduct of some other process. In this review an attempt will be made to describe a cross-section of these cavitation phenomena. In the byproduct category we describe some of the cavitation generated by head injuries and in artifical heart valves. In the utilization category we review the cavitation produced during lithotripsy and phacoemulsification. As an additional example we describe the nucleation suppression phenomena encountered in supersaturated oxygen solution injection. Virtually all of these cavitation and nucleation phenomena are critically dependent on the existence of nucleation sites. In most conventional engineering contexts, the prediction and control of nucleation sites is very uncertain even when dealing with a simple liquid like water. In complex biological fluids, there is a much greater dearth of information. Moreover, all these biological contexts seem to involve transient, unsteady cavitation. Consequently they involve the difficult issue of the statistical coincidence of nucleation sites and transient low pressures. The unsteady, transient nature of the phenomena means that one must be aware of the role of system dynamics in vivo and in vitro. For example, the artificial heart valve problem clearly demonstrates the importance of structural flexibility in determining cavitation occurrence and cavitation damage. Other system issues are very important in the design of in vitro systems for the study of cavitation consequences. Another common feature of these phenomena is that often the cavitation occurs in the form of a cloud of bubbles and thus involves bubble interactions and bubble cloud phenomena. In this review we summarize these issues and some of the other characteristics of biological cavitation phenomena. NOMENCLATURE A Typical dimension of the cloud of bubbles. R Typical equilibrium radius of the bubbles. α Equilibrium void fraction in the cloud. β Interaction parameter, α A/R