Abstract-Endocardial cushions are critical to maintain unidirectional blood flow under constantly increasing hemodynamic forces, but the interrelationship between endocardial cushion structure and the mechanics of atrioventricular junction function is poorly understood. Atrioventricular (AV) canal motions and blood velocities of embryonic chicks at Hamburger and Hamilton (HH) stages 17, 21, and 25 were quantified using ultrasonography. Similar to the embryonic zebrafish heart, the HH17 AV segment functions like a suction pump, with the cushions expanding in a wave during peak myocardial contraction and becoming undetectable during the relaxation phase. By HH25, the AV canal contributes almost nothing to the piston-like propulsion of blood, but the cushions function as stoppers apposing blood flow with near constant thickness. Using a custom built mesomechanical testing system, we quantified the nonlinear pseudoelastic biomechanics of developing AV cushions, and found that both AV cushions increased in effective modulus between HH17 and HH25. Enzymatic digestion of major structural constituent collagens or glycosaminoglycans resulted in distinctly different stress-strain curves suggestive of their individual contributions. Mixture theory using histologically determined volume fractions of cells, collagen, and glycosaminoglycans showed good prediction of cushion material properties regardless of stage and cushion position. Key Words: chick Ⅲ development Ⅲ modeling Ⅲ ultrasound Ⅲ flow Ⅲ aspiration T he development of the atrioventricular (AV) and semilunar valves of the heart from the endocardial cushions occurs concomitantly with a constant barrage of hemodynamic and mechanical forces. Several studies have demonstrated that both blood pressure and velocities increase during morphological development in the heart, implying that the stresses on the endocardial cushions are also increasing. [1][2][3] Early investigations highlighted the motions of cushions in concert with the contracting myocardium, suggesting that they serve a valve-like function before valves form. 4 However, a recent study showed that the atrioventricular canal in the tubular early zebrafish heart functions like a suction pump, in contrast to the peristaltic mechanism previously described. 5 These observations raise no controversy with respect to current understanding of transitions that occur structurally and molecularly in the myocardium during early tube heart development, but raise major questions with respect to the mechanism through which endocardial cushions function in promoting unidirectional blood flow during the transition from tubular heart to a septated structure. In this study we examined the mechanical properties and myocardial/endocardial cushion mechanical interaction in 3 stages of cardiac development in the chick embryo to better understand how the mechanical properties of the cushions contribute to their functional roles.Various mutant models demonstrate that genetic defects compromising valve structural maturation result in s...