The evolution of polyurethane heart valve replacements: How chemistry translates to the clinic

Crago, Matthew; Lee, Aeryne; Farajikhah, Syamak; Oveissi, Farshad; Fletcher, David F.; Dehghani, Fariba; Winlaw, David S.; Naficy, Sina

doi:10.1016/j.mtcomm.2022.104916

Cited by 16 publications

(14 citation statements)

References 228 publications

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“…However, not every deformation is reversible. In an energetically favorable state, polymers change their shape irreversibly (plastic deformation) [ 73 ]. The boundary of plastic deformation depends on the properties of the material itself, the nature of the applied speed and force, as well as its duration.…”

Section: Historical Backgroundmentioning

confidence: 99%

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Резвова

Klyshnikov

Грицкевич³

et al. 2023

IJMS

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The development of a novel artificial heart valve with outstanding durability and safety has remained a challenge since the first mechanical heart valve entered the market 65 years ago. Recent progress in high-molecular compounds opened new horizons in overcoming major drawbacks of mechanical and tissue heart valves (dysfunction and failure, tissue degradation, calcification, high immunogenic potential, and high risk of thrombosis), providing new insights into the development of an ideal artificial heart valve. Polymeric heart valves can best mimic the tissue-level mechanical behavior of the native valves. This review summarizes the evolution of polymeric heart valves and the state-of-the-art approaches to their development, fabrication, and manufacturing. The review discusses the biocompatibility and durability testing of previously investigated polymeric materials and presents the most recent developments, including the first human clinical trials of LifePolymer. New promising functional polymers, nanocomposite biomaterials, and valve designs are discussed in terms of their potential application in the development of an ideal polymeric heart valve. The superiority and inferiority of nanocomposite and hybrid materials to non-modified polymers are reported. The review proposes several concepts potentially suitable to address the above-mentioned challenges arising in the R&D of polymeric heart valves from the properties, structure, and surface of polymeric materials. Additive manufacturing, nanotechnology, anisotropy control, machine learning, and advanced modeling tools have given the green light to set new directions for polymeric heart valves.

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Section: Historical Backgroundmentioning

confidence: 99%

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Резвова

Klyshnikov

Грицкевич³

et al. 2023

IJMS

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“…Some Eudragit ® samples are insoluble and exhibit pH-independent swelling properties; they are used for the development of sustained DDS materials. Thermoplastic medical-grade polyurethanes are used in commercial products: vaginal rings, stents, breast implants, heart valves, pacemaker leads, and also in medical thin-walled tubes and vascular catheters [ 38 , 39 ]. The chemical structure of polyurethanes combines hard (isocyanate end-groups) and soft (carbon chains with hydroxyl end-groups) segments, responsible respectively for the mechanical resistance and elastomeric behavior [ 40 ].…”

Section: Properties Of Organic Polymers To Attend Pharmaceutical and ...mentioning

confidence: 99%

Biomaterials Based on Organic Polymers and Layered Double Hydroxides Nanocomposites: Drug Delivery and Tissue Engineering

et al. 2023

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The development of biomaterials has a substantial role in pharmaceutical and medical strategies for the enhancement of life quality. This review work focused on versatile biomaterials based on nanocomposites comprising organic polymers and a class of layered inorganic nanoparticles, aiming for drug delivery (oral, transdermal, and ocular delivery) and tissue engineering (skin and bone therapies). Layered double hydroxides (LDHs) are 2D nanomaterials that can intercalate anionic bioactive species between the layers. The layers can hold metal cations that confer intrinsic biological activity to LDHs as well as biocompatibility. The intercalation of bioactive species between the layers allows the formation of drug delivery systems with elevated loading capacity and modified release profiles promoted by ion exchange and/or solubilization. The capacity of tissue integration, antigenicity, and stimulation of collagen formation, among other beneficial characteristics of LDH, have been observed by in vivo assays. The association between the properties of biocompatible polymers and LDH-drug nanohybrids produces multifunctional nanocomposites compatible with living matter. Such nanocomposites are stimuli-responsive, show appropriate mechanical properties, and can be prepared by creative methods that allow a fine-tuning of drug release. They are processed in the end form of films, beads, gels, monoliths etc., to reach orientated therapeutic applications. Several studies attest to the higher performance of polymer/LDH-drug nanocomposite compared to the LDH-drug hybrid or the free drug.

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“…142,143 Out of the various polymers explored for polymeric valves, polyurethanes are most promising due to their biomimetic mechanical properties that combine strength and elasticity, 115,144 with those based on siloxane groups exhibiting the greatest resistance to biofouling, compared to those based on ester, ether or carbonate groups. [144][145][146][147] While polyurethanes are more resistant to biofouling than materials such as poly(ethylene terephthalate) 148 and polytetrafluoroethylene, 149 they are inferior to poly(styrene-b-isobutylene-b-styrene) 150,151 and ePTFE. 148 Nonetheless, all synthetic biomaterials remain prone to biofouling, 63,121 necessitating additional strategies to diminish this susceptibility.…”

Section: Surface Modifications For Antifouling Biomaterialsmentioning

confidence: 99%

Pediatric pulmonary valve replacements: Clinical challenges and emerging technologies

Crago

Winlaw

Farajikhah

et al. 2023

Bioengineering & Transla Med

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Congenital heart diseases (CHDs) frequently impact the right ventricular outflow tract, resulting in a significant incidence of pulmonary valve replacement in the pediatric population. While contemporary pediatric pulmonary valve replacements (PPVRs) allow satisfactory patient survival, their biocompatibility and durability remain suboptimal and repeat operations are commonplace, especially for very young patients. This places enormous physical, financial, and psychological burdens on patients and their parents, highlighting an urgent clinical need for better PPVRs. An important reason for the clinical failure of PPVRs is biofouling, which instigates various adverse biological responses such as thrombosis and infection, promoting research into various antifouling chemistries that may find utility in PPVR materials. Another significant contributor is the inevitability of somatic growth in pediatric patients, causing structural discrepancies between the patient and PPVR, stimulating the development of various growthaccommodating heart valve prototypes. This review offers an interdisciplinary perspective on these challenges by exploring clinical experiences, physiological understandings, and bioengineering technologies that may contribute to device development. It thus aims to provide an insight into the design requirements of next-generation PPVRs to advance clinical outcomes and promote patient quality of life.

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The evolution of polyurethane heart valve replacements: How chemistry translates to the clinic

Cited by 16 publications

References 228 publications

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Biomaterials Based on Organic Polymers and Layered Double Hydroxides Nanocomposites: Drug Delivery and Tissue Engineering

Pediatric pulmonary valve replacements: Clinical challenges and emerging technologies

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