Replacement cardiac valves have been in use since the 1950s, and today represent the most widely used cardiovascular devices. One type of replacement cardiac valve, the polyurethane heart valve, has been around since the first stages of prosthesis development, and has made advances along with the development of biological and mechanical heart valves over the past 60 years. During this time, problems with durability and biocompatibility have held back polyurethane valves, but progress in materials and manufacturing techniques can lead the way to a brighter future for these devices and their huge potential. This article describes previous efforts to manufacture polyurethane heart valves, highlights the challenges of manufacturing and explains the factors influencing durability and successful functioning of such a device.
The flow field in the respiratory and vascular system is known to be influenced by the flexibility of the walls. However, up to now, most of the experimental biofluidic investigations have been performed in rigid models due to the complexity and necessity of optical access. In this paper, a facility and measurement techniques for studying oscillating and pulsatile flow in elastic vessels will be described. The investigated vessel models have been adapted such that fluid-mechanical and structure-mechanical characteristics represent realistic blood flows in medium blood vessels. That is, characteristic parameters, i.e., the Reynolds and Womersley number, as well as mechanical properties of the flexible wall, i.e., the Young's modulus and the material compliance, have been chosen to reasonably represent realistic flow conditions. First, a method to manufacture elastic models, which mimic the structure-mechanical properties of vascular vessels is described. The models possess a tunable compliance and are made of transparent polydimethylsiloxane. Second, the experimental setup of the flow facility will be elucidated. The flow facility allows to mimic pulsatile flow at physiologically relevant Reynolds and Womersley numbers. The precise form of the flow cycle can individually be controlled. Water/glycerine is used as flow medium for refractive index matching particle image velocimetry (PIV) measurements. The PIV recordings not only allow to assess the mean cross-sectional flow field but also further enable to simultaneously detect the movement of the flexible wall. Additionally, the local wall-shear stress can be obtained from the single-pixel line resolved near-wall flow field. To confirm the flow conditions of the oscillatory laminar flow inside the flow facility and to evaluate the ability to assess the flow field, measurements in a straight, uniform diameter, rigid Plexiglas pipe under identical conditions to those of the oscillating flow in the flexible vessel have been performed. The measurements of oscillating flow in the rigid pipe corroborate the experimentally obtained flow field and the wall-shear stress to well confirm Womersley's analytical solution and thereby evidence the quality of the flow facility and of the measurement techniques. To further study the detectability of the vessel deformation, oscillating flow at Reynolds numbers based on the non-dilated vessel diameter D and peak velocities Re D ranging from 1,000 to 1,750 and at Womersley numbers a ranging from 5 to 17.5 has been investigated in an elastic vessel.
In the development of new hemocompatible biomaterials, surface modification appears to be a suitable method in order to reduce the thrombogenetic potential of such materials. In this study, polycarbonate-urethane (PCU) tubes with different surface microstructures to be used for aortic heart valve models were investigated with regard to the thrombogenicity. The surface structures were produced by using a centrifugal casting process for manufacturing PCU tubes with defined casting mold surfaces which are conferred to the PCU surface during the process. Tubes with different structures defined by altering groove widths were cut into films and investigated under dynamic flow conditions in contact with porcine blood. The analysis was carried out by laser scanning microscopy which allowed for counting various morphological types of platelets with regard to the grade of activation. The comparison between plain and shaped PCU samples showed that the surface topography led to a decline of the activation of the coagulation cascade and thus to the reduction of the fibrin synthesis. Comparing different types of structures revealed that smooth structures with a small groove width (d ~ 3 μm) showed less platelet activation as well as less adhesion in contrast to a distinct wave structure (d ~ 90 μm). These results prove surface modification of polymer biomaterials to be a suitable method for reducing thrombogenicity and hence give reason for further alterations and improvements.
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