Measurement of Porcine Aortic and Pulmonary Valve Geometry and Design for Implantable Tissue Valve

Abstract

Background: As life expectancy has been increased, the cardiac valve disease has been increased. In past, mechanical valve for valve replacement surgery was used widely, but it has many weaknesses, such as hemorrhage, teratogenic effect caused by warfarin, acute mechanical failure, taking warfarin during life, etc. So, the tissue valve is used widely and researches for durability of tissue valve are in progress. Tissue valves being used are all imported in Korea, and there is a lack of information on its geometry and design. So, we studied the geometry of porcine aortic and pulmonary valve, and tried to suggest theoretical basis for making the aortic and pulmonary valve. Material and Method: We harvested aortic and pulmonary valves of 25 pigs and measured the geometry of valve at fresh and glutaraldehyde (GA) fixed state. In each group, we measured the diameter of the base, diameter of commissure, valve height, commissural height, etc. Also, for making implantable porcine and bovine pericardial valve, we designed the valve stent form, thickness, height, and leaflet size, form, thickness by different size of valve. Result: The aortic and pulmonary valve geometry and ratio were measured in each group. The right coronary cusp of aortic valve and right facing cusp of pulmonary valve was bigger than other cusps and non coronary cusp was smaller than others (RCC：NCC：LCC=1：0.88：1). Valve height was correlated to the leaflet size. We designed the outer diameter of stented porcine aortic valve from 19 mm to 33 mm and designed stent height and width, using previous measured ratio of each structure, stent thickness, working thickness (for making valve). Also, we designed the size of stent and form for stented bovine pericardial valve, considering diameter of valve, leaflet length, height and leaflet minimum coaptation area. Conclusion: By measuring of 25 pig's aortic and pulmonary valve geometry and ratio, we can make theoretical basis for making implantable stented porcine valve and bovine pericardial valve in various size. After making implantable valve using these data, it is necessary to do in vivo and in vitro researches, furthermore.

Valved Conduit with Glutaraldehyde-Fixed Bovine Pericardium Treated by Anticalcification Protocol

“…One bovine pericardium with three bulging sinuses was used as the conduit wall, and three valve leaflets were made by anastomosing the sinus-shaped valves made of another bovine pericardium to the edge of the bulging sinuses. In this study, bulging sinuses were formed on a pericardial valved conduit having a diameter of 15 mm by using a specially designed mold [ 12 ].…”

“…We also developed a specially designed mold for the manufacture of the valved conduit [12] and produced a valved conduit with the GA-fixed bovine pericardia treated with our combined anticalcification protocol, which had been proven effective in small-animal experiments [6]. In this study, preclinical safety and efficacy with in vitro mock circulation and in vivo large-animal circulatory models were evaluated for this valved conduit.…”

“…Our treatment targeted at the prevention of calcification includes the extraction of phospholipids [ 6 , 8 , 9 ], neutralization of residual unbound aldehyde groups of GA [ 6 , 8 , 9 ], and decellularization [ 6 , 10 , 11 ]. We also developed a specially designed mold for the manufacture of the valved conduit [ 12 ] and produced a valved conduit with the GA-fixed bovine pericardia treated with our combined anticalcification protocol, which had been proven effective in small-animal experiments [ 6 ]. In this study, preclinical safety and efficacy with in vitro mock circulation and in vivo large-animal circulatory models were evaluated for this valved conduit.…”

Development of Novel Combined Anticalcification Protocols Including Immunologic Modification for Prolonged Durability of Cardiac Xenograft

“…11 The mold was made of silicone and epolene wax to create a valve conduit with bulging sinuses. 11 The mold was made of silicone and epolene wax to create a valve conduit with bulging sinuses.…”