Current developments and future prospects for heart valve replacement therapy

Kidane, Asmeret G.; Burriesci, G; Cornejo, Patricia; Dooley, A; Sarkar, Sandip; Bonhoeffer, Philipp; Edirisinghe, Mohan; Seifalian, Alexander M.

doi:10.1002/jbm.b.31151

Cited by 88 publications

(49 citation statements)

References 119 publications

(137 reference statements)

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“…Both types of prostheses significantly enhance the quality of life, but also have several limitations. For example, mechanical valves require lifelong anticoagulation therapy to prevent thromboembolism, and bioprosthetic valves have a limited durability (Kidane et al, 2009;Pibarot and Dumesnil, 2009). Most importantly, both valve substitutes are unable to grow, repair, and remodel in response to changing demands.…”

Section: Introductionmentioning

confidence: 99%

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Loerakker

Argento

Oomens

et al. 2013

Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotran

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Tissue engineering represents a promising technique to overcome the limitations of the current valve replacements, since it allows for creating living autologous heart valves that have the potential to grow and remodel. However, also this approach still faces a number of challenges. One particular problem is regurgitation, caused by cell-mediated tissue retraction or the mismatch in geometrical and material properties between tissue-engineered heart valves (TEHVs) and their native counterparts. The goal of the present study was to assess the influence of valve geometry and tissue anisotropy on the deformation profile and closed configuration of TEHVs. To achieve this aim, a range of finite element models incorporating different valve shapes was developed, and the constitutive behavior of the tissue was modeled using an established computational framework, where the degree of anisotropy was varied between values representative of TEHVs and native valves. The results of this study suggest that valve geometry and tissue anisotropy are both important to maximize the radial strains and thereby the coaptation area. Additionally, the minimum degree of anisotropy that is required to obtain positive radial strains was shown to depend on the valve shape and the pressure to which the valves are exposed. Exposure to pulmonary diastolic pressure only yielded positive radial strains if the anisotropy was comparable to the native situation, whereas considerably less anisotropy was required if the valves were exposed to aortic diastolic pressure. AbstractTissue engineering represents a promising technique to overcome the limitations of the current valve replacements, since it allows for creating living autologous heart valves that have the potential to grow and remodel. However, also this approach still faces a number of challenges. One particular problem is regurgitation, caused by cell-mediated tissue retraction or the mismatch in geometrical and material properties between tissue-engineered heart valves (TEHVs) and their native counterparts. The goal of the present study was to assess the influence of valve geometry and tissue anisotropy on the deformation profile and closed configuration of TEHVs. To achieve this aim, a range of finite element models incorporating different valve shapes was developed, and the constitutive behavior of the tissue was modeled using an established computational framework, where the degree of anisotropy was varied between values representative of TEHVs and native valves. The results of this study suggest that valve geometry and tissue anisotropy are both important to maximize the radial strains and thereby the coaptation area. Additionally, the minimum degree of anisotropy that is required to obtain positive radial strains was shown to depend on the valve shape and the pressure to which the valves are exposed. Exposure to pulmonary diastolic pressure only yielded positive radial strains if the anisotropy was comparable to the native situation, whereas considerably less anisotropy was ...

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Section: Introductionmentioning

confidence: 99%

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Loerakker

Argento

Oomens

et al. 2013

Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotran

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“…A biomaterial or scaffold for tissue engineering should provide not only mechanical support for the cell proliferation but also they must be versatile to give the required anatomical shape (Kidane et al, 2009). The decellularization of collagenous tissues has been explored as the ECM may serve as appropriate biological scaffold for cell attachment and proliferation.…”

Section: Effect Of Decellularization Treatment On Tissue Propertiesmentioning

confidence: 99%

Decellularization, Stabilization and Functionalization of Collagenous Tissues Used as Cardiovascular Biomaterials

Mendoza-Novelo¹,

Cauich-Rodríguez²

2011

Biomaterials - Physics and Chemistry

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“…Although current mechanical and biological heart valve replacements improve patient survival and quality of life, problems such as thrombosis, infection and limited durability still occur and none of the current conventional valve replacements has the capacity to grow in young patients (Alpert and Dalen, 1987;Roudaut et al, 2007;Kidane et al, 2009). For young patients under the age of 18 years with severe aortic heart valve disease, the Ross procedure using a pulmonary autograft is the preferred replacement valve substitute (Alsoufi et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

In vitro biomechanical and hydrodynamic characterisation of decellularised human pulmonary and aortic roots

Desai

Vafaee

Rooney

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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A B S T R A C TBackground and purpose of the study: The use of decellularised biological heart valves in the replacement of damaged heart valves offers a promising solution to reduce the degradation issues associated with existing cryopreserved allografts. The purpose of this study was to assess the effect of low concentration sodium dodecyl sulphate decellularisation on the in vitro biomechanical and hydrodynamic properties of cryopreserved human aortic and pulmonary roots. Method: The biomechanical and hydrodynamic properties of cryopreserved decellularised human aortic and pulmonary roots were fully characterised and compared to cellular human aortic and pulmonary roots in an unpaired study. Following review of these results, a further study was performed to investigate the influence of a specific processing step during the decellularisation protocol ('scraping') in a paired comparison, and to improve the method of the closed valve competency test by incorporating a more physiological boundary condition. Results: The majority of the biomechanical and hydrodynamic characteristics of the decellularised aortic and pulmonary roots were similar compared to their cellular counterparts. However, several differences were noted, particularly in the functional biomechanical parameters of the pulmonary roots. However, in the subsequent paired comparison of pulmonary roots with and without decellularisation, and when a more appropriate physiological test model was used, the functional biomechanical parameters for the decellularised pulmonary roots were similar to the cellular roots. Conclusion: Overall, the results demonstrated that the decellularised roots would be a potential choice for clinical application in heart valve replacement.

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Current developments and future prospects for heart valve replacement therapy

Cited by 88 publications

References 119 publications

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Decellularization, Stabilization and Functionalization of Collagenous Tissues Used as Cardiovascular Biomaterials

In vitro biomechanical and hydrodynamic characterisation of decellularised human pulmonary and aortic roots

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