Alternative mechanical heart valves for the developing world

Abstract

Due to the prevalence of rheumatic heart disease in the developing world, mechanical heart valves in the younger patient population remain the prostheses of choice if repair is not feasible. Despite their durability, mechanical valves are burdened by coagulation and thromboembolism. Modern design tools can be utilized during the design process of mechanical valves, which allow a more systematic design approach and more detailed analysis of the blood flow through and around valves. These tools include computer-aided design, manufacturing, and engineering, such as computational fluid dynamics and finite element analysis, modern manufacturing techniques such as additive manufacturing, and sophisticated in-vitro and in-vivo tests. Following this systematic approach, a poppet valve was redesigned and the results demonstrate the benefits of the method. More organized flow patterns and fewer complex fluid structures were observed. The alternative trileaflet valve design has also been identified as a potential solution and, if a similar design approach is adopted, it could lead to the development of an improved mechanical heart valve in the future. It is imperative that researchers in developing countries continue their search for a mechanical heart valve with a reduced thromboembolic risk, requiring less or no anticoagulation.

Hydrogel-polyurethane fiber composites with enhanced microarchitectural control for heart valve replacement

“…6,7 Unfortunately, the bioprosthetic valve has limited durability with 50% failing within 15 years due to structural degeneration resulting from material fatigue and calcification. 2,7,8 Researchers continue to pursue polymeric valves as an alternative clinical option that offer the potential to combine the durability of mechanical valves and the hemocompatibility of bioprosthetic valves. 6…”

“…6,7 Unfortunately, the bioprosthetic valve has limited durability with 50% failing within 15 years due to structural degeneration resulting from material fatigue and calcification. 2,7,8 Researchers continue to pursue polymeric valves as an alternative clinical option that offer the potential to combine the durability of mechanical valves and the hemocompatibility of bioprosthetic valves. 6 Polymeric valves have been investigated since the early 1960's offering a high degree of design freedom, reduced valve-to-valve variability, and reduced cost compared to bioprosthetic valves.…”

Hydrogel‐polyurethane fiber composites with enhanced microarchitectural control for heart valve replacement

“…Over 290,000 patients require heart valve replacements worldwide, with an estimated increase to 850,000 by 2050. 1,2 Current replacement heart valve options include mechanical valves and tissue-based bioprosthetic valves. Although mechanical valves provide excellent durability, patients are required to be on lifelong anticoagulants.…”

“…6,7 Unfortunately, the bioprosthetic valve has limited durability with 50% failing within 15 years due to structural degeneration resulting from material fatigue and calcification. 2,7,8 Researchers continue to pursue polymeric valves as an alternative clinical option that offer the potential to combine the durability of mechanical valves and the hemocompatibility of bioprosthetic valves. 6 Polymeric valves have been investigated since the early 1960s offering a high degree of design freedom, reduced valve-to-valve variability, and reduced cost compared to bioprosthetic valves.…”

Multiscale Characterization of Isotropic Pyrolytic Carbon Used for Mechanical Heart Valve Production

“…After the deposition process of PyC, due to the impossibility of real time monitoring of coating growth, a machinery procedure is required to obtain MHVs with proper shape and geometry [17]. Moreover, further surface treatment is necessary to achieve appropriate roughness values of the exposed surfaces, conferring the required thromboresistance characteristics to the device [21][22][23].…”