Flexible Leaflet Polymeric Heart Valves

Bezuidenhout, Deon; Zilla, Peter

doi:10.1007/8415_2013_166

Cited by 8 publications

(8 citation statements)

References 124 publications

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“…17 The initial results of implanting these valves led to a significant failure mainly due to their limited durability. 82,84 However, over the past decade, there has been significant progress toward development of these valves with improved hemodynamics and durability, and in some cases lower thrombogenicity.…”

Section: Polymeric Heart Valvesmentioning

confidence: 99%

Emerging Trends in Heart Valve Engineering: Part I. Solutions for Future

et al. 2014

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Abstract-As the first section of a multi-part review series, this section provides an overview of the ongoing research and development aimed at fabricating novel heart valve replacements beyond what is currently available for patients. Here we discuss heart valve replacement options that involve a biological component or process for creation, either in vitro or in vivo (tissue-engineered heart valves), and heart valves that are fabricated from polymeric material that are considered permanent inert materials that may suffice for adults where growth is not required. Polymeric materials provide opportunities for cost-effective heart valves that can be more easily manufactured and can be easily integrated with artificial heart and ventricular assist device technologies. Tissue engineered heart valves show promise as a regenerative patient specific model that could be the future of all valve replacement. Because tissue-engineered heart valves depend on cells for their creation, understanding how cells sense and respond to chemical and physical stimuli in their microenvironment is critical and therefore, is also reviewed.

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Section: Polymeric Heart Valvesmentioning

confidence: 99%

Emerging Trends in Heart Valve Engineering: Part I. Solutions for Future

et al. 2014

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“…In addition to adverse hemodynamics, blood-material interactions can result in thrombosis 7, 10 . For example, various synthetic valves have been designed to exhibit similar hemodynamics to bioprosthetic and native heart valves, yet they still suffer from thrombotic complications 22, 35, 84, 85 .…”

Section: Introductionmentioning

confidence: 99%

“…For example, various synthetic valves have been designed to exhibit similar hemodynamics to bioprosthetic and native heart valves, yet they still suffer from thrombotic complications 22, 35, 84, 85 . Therefore, various material treatments have been developed in attempts to mitigate this risk 7, 41 . One approach is to weaken the interaction of cell and protein adhesion to a surface by using hydrophilic surfaces or through the application of an unreactive protein to the surface 42, 44, 51, 66 .…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Performance and Thrombogenic Properties of a Superhydrophobic Bileaflet Mechanical Heart Valve

et al. 2016

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In this study, we explore how blood-material interactions and hemodynamics are impacted by rendering a clinical quality 25 mm St. Jude Medical Bileaflet mechanical heart valve (BMHV) superhydrophobic (SH) with the aim of reducing thrombo-embolic complications associated with BMHVs. Basic cell adhesion is evaluated to assess blood-material interactions, while hemodynamic performance is analyzed with and without the SH coating. Results show that a SH coating with a receding contact angle (CA) of 160º strikingly eliminates platelet and leukocyte adhesion to the surface. Alternatively, many platelets attach to and activate on pyrolytic carbon (receding CA=47), the base material for BMHVs. We further show that the performance index increases by 2.5% for coated valve relative to an uncoated valve, with a maximum possible improved performance of 5%. Both valves exhibit instantaneous shear stress below 10 N/m2 and Reynolds Shear Stress below 100 N/m2. Therefore, a SH BMHV has the potential to relax the requirement for antiplatelet and anticoagulant drug regimens typically required for patients receiving MHVs by minimizing blood-material interactions, while having a minimal impact on hemodynamics. We show for the first time that SH-coated surfaces may be a promising direction to minimize thrombotic complications in complex devices such as heart valves.

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“…Bioprosthetic and mechanical heart valves are the most widely implanted heart valve prostheses to-date, but the former suffers from durability issues due to calcification and other factors, while the latter suffers from thromboembolic risk (Bezuidenhout and Zilla, 2014; Dasi et al, 2009; Oxenham et al, 2003; Sacks and Yoganathan, 2007; Zilla et al, 2008). To counter the latter issue, patients receiving mechanical valves require lifelong anticoagulant and antiplatelet therapies to mitigate the risk for thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Reynolds shear stress for textile prosthetic heart valves in relation to fabric design

Bark

Yousefi

Forleo

et al. 2016

Journal of the Mechanical Behavior of Biomedical Materials

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The most widely implanted prosthetic heart valves are either mechanical or bioprosthetic. While the former suffers from thrombotic risks, the latter suffers from a lack of durability. Textile valves, alternatively, can be designed with durability and to exhibit hemodynamics similar to the native valve, lowering the risk for thrombosis. Deviations from native valve hemodynamics can result in an increased Reynolds Shear Stress (RSS), which has the potential to instigate hemolysis or shear-induced thrombosis. This study is aimed at characterizing flow in multiple textile valve designs with an aim of developing a low profile valve. Valves were created using a shaping process based on heating a textile membrane and placed within a left heart simulator. Turbulence and bulk hemodynamics were assessed through particle imaging velocimetry (PIV), along with flow and pressure measurements. Overall, RSS was reduced for low profile valves relative to high profile valves, but was otherwise similar among low profile valves. However, leakage was found in 3 of the 4 low profile valve designs driving the fabric design for low profile valves. Through textile design, low profile valves can be created with favorable hemodynamics.

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Flexible Leaflet Polymeric Heart Valves

Cited by 8 publications

References 124 publications

Emerging Trends in Heart Valve Engineering: Part I. Solutions for Future

Emerging Trends in Heart Valve Engineering: Part I. Solutions for Future

Hemodynamic Performance and Thrombogenic Properties of a Superhydrophobic Bileaflet Mechanical Heart Valve

Reynolds shear stress for textile prosthetic heart valves in relation to fabric design

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