Comparison of biomechanical and structural properties between human aortic and pulmonary valve (original) (raw)
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Comparison of biomechanical and structural properties between human aortic and pulmonary valve*1
European Journal of Cardio-Thoracic Surgery, 2004
Objective: Pulmonary valve autografts have been reported as clinically effective for replacement of diseased aortic valve (Ross procedure). Published data about pulmonary valve mechanical and structural suitability as a long-term substitute for aortic valve are limited. The aim of this study was to compare aortic and pulmonary valve properties. Methods: Experimental studies of biomechanical properties and structure of aortic and pulmonary valves were carried out on pathologically unchanged human heart valves, collected from 11 cadaveric hearts. Biomechanical properties of 84 specimens (all valve elements: cusps, fibrous ring, commissures, sinotubular junction, sinuses) were investigated using uniaxial tensile tests. Ultrastructure was studied using transmission and scanning electron microscopy. Results: Ultimate stress in circumferential direction for pulmonary valve cusps is higher than for aortic valve (2.78^1.05 and 1.74^0.29 MPa, respectively). Ultimate stress in radial direction for pulmonary and aortic cusps is practically the same (0.29^0.06 and 0.32^0.04 MPa, respectively). In ultrastructural study, different layout and density in each construction element are determined. The aortic and pulmonary valves have common ultrastructural properties. Conclusions: Mechanical differences between aortic and pulmonary valve are minimal. Ultrastructural studies show that the aortic and pulmonary valves have similar structural elements and architecture. This investigation suggests that the pulmonary valve can be considered mechanically and structurally suitable for use as an aortic valve replacement. q
Biomechanical properties of native and tissue engineered heart valve constructs
Journal of Biomechanics, 2013
Due to the increasing number of heart valve diseases, there is an urgent clinical need for off-the-shelf tissue engineered heart valves. While significant progress has been made toward improving the design and performance of both mechanical and tissue engineered heart valves (TEHVs), a human implantable, functional, and viable TEHV has remained elusive. In animal studies so far, the implanted TEHVs have failed to survive more than a few months after transplantation due to insufficient mechanical properties. Therefore, the success of future heart valve tissue engineering approaches depends on the ability of the TEHV to mimic and maintain the functional and mechanical properties of the native heart valves. However, aside from some tensile quasistatic data and flexural or bending properties, detailed mechanical properties such as dynamic fatigue, creep behavior, and viscoelastic properties of heart valves are still poorly understood. The need for better understanding and more detailed characterization of mechanical properties of tissue engineered, as well as native heart valve constructs is thus evident. In the current review we aim to present an overview of the current understanding of the mechanical properties of human and common animal model heart valves. The relevant data on both native and tissue engineered heart valve constructs have been compiled and analyzed to help in defining the target ranges for mechanical properties of TEHV constructs, particularly for the aortic and the pulmonary valves. We conclude with a summary of perspectives on the future work on better understanding of the mechanical properties of TEHV constructs.
Mechanics of the pulmonary valve in the aortic position
Journal of the Mechanical Behavior of Biomedical Materials, 2014
Mathematical models can provide valuable information to assess and evaluate the mechanical behavior and remodeling of native tissue. A relevant example when studying collagen remodeling is the Ross procedure because it involves placing the pulmonary autograft in the more demanding aortic valve mechanical environment. The objective of this study was therefore to assess and evaluate the mechanical differences between the aortic valve and pulmonary valve and the remodeling that may occur in the pulmonary valve when placed in the aortic position. The results from biaxial tensile tests of pairs of human aortic and pulmonary valves were compared and used to determine the parameters of a structurally based constitutive model. Finite element analyzes were then performed to simulate the mechanical response of both valves to the aortic diastolic load. Additionally, remodeling laws were applied to assess the remodeling of the pulmonary valve leaflet to the new environment. The pulmonary valve showed to be more extensible and less anisotropic than the aortic valve. When exposed to aortic pressure, the pulmonary leaflet appeared to remodel by increasing its thickness and reorganizing its collagen fibers, rotating them toward the circumferential direction.
Interactive cardiovascular and thoracic surgery, 2009
The major problem with heart valve bioprostheses made from chemically treated porcine aortic valves is their limited longevity caused by gradual deterioration, which has a causal link with valve tissue mechanical properties. To our best knowledge, there are no published studies on the mechanical properties of modern, commercially available bioprostheses comparing them to native human valves. The objective of this study is to determine the mechanical properties of St Jude Epic bioprostheses and to compare them with native human and porcine aortic valves. Leaflets from eight porcine aortic valves and six Epic bioprostheses were analyzed using uni-axial tensile tests in radial and circumferential directions. Mechanical properties of human valves have been previously published by our group. Results are represented as mean values+/-S.D. Circumferential direction. Modulus of elasticity of Epic bioprostheses in circumferential direction at the level of stress 1.0 MPa is 101.99+/-58.24 MPa,...
Interactive CardioVascular and Thoracic Surgery, 2016
The aim of this study is to determine whether patients undergoing the Ross procedure with bicuspid aortic valves have pulmonary artery biomechanical properties different from those with tricuspid valves. METHODS: Thirty-two pulmonary arteries and 20 aortas were obtained from patients undergoing the Ross procedure at the time of surgery, from a cohort of 32 patients. The aortic valve was tricuspid in 5 patients (16%), bicuspid in 18 patients (56%) and unicuspid in 9 patients (28%). Histological analysis and ex vivo equi-biaxial tensile testing completed within 8 hours of surgery were used to evaluate differences in patient groups and between the pulmonary artery and the ascending aorta. RESULTS: There was no difference in thickness among pulmonary arteries when compared according to aortic valve phenotype (P = 0.94). There was no difference in the tensile tissue properties among aortas and pulmonary arteries when compared according to aortic valve phenotype, in either the circumferential or longitudinal axis. When compared according to the main surgical indication, pulmonary artery walls from patients with pure aortic regurgitation were less stiff than their counterparts (aortic regurgitation: 0.055 ± 0.037 MPa, aortic stenosis: 0.103 ± 0.051 MPa, mixed disease: 0.110 ± 0.044 MPa and aortic valve endocarditis: 0.216 ± 0.033 MPa, P = 0.002). There was no difference in the number of elastic lamellae in pulmonary artery specimens from the three different aortic valve phenotypes, as well as in the aortic specimens. CONCLUSIONS: No significant differences were observed in the biomechanical properties of pulmonary arteries when compared according to aortic valve phenotype.
Nondestructive and Noninvasive Assessment of Mechanical Properties in Heart Valve Tissue Engineering
Tissue Engineering Part A, 2009
Despite recent progress, mechanical behavior of tissue-engineered heart valves still needs improvement when native aortic valves are considered as a benchmark. Although it is known that cyclic straining enhances tissue formation, optimal loading protocols have not been defined yet. To obtain a better understanding of the effects of mechanical conditioning on tissue development, mechanical behavior of tissue constructs should be monitored and controlled during culture. However, currently used methods for mechanical characterization (e.g., tensile and indentation tests) are destructive and are only performed at the end-stage of tissue culture. In this study, an inverse experimental-numerical approach was developed that enables a noninvasive and nondestructive assessment of mechanical properties of engineered heart valves. The applied pressure and volumetric deformation of an engineered heart valve were measured during culture, and served as input for the estimation of mechanical properties using a computational model. To validate the method, six heart valves were cultured, and the mechanical properties obtained from the inverse experimental-numerical approach were in good agreement with uniaxial tensile test data. The method provides a real-time, noninvasive and nondestructive functionality and quality check of tissue-engineered heart valves and can be used to monitor and control the evolution of mechanical properties during tissue culture.
Hemodynamics and mechanical behaviors of aortic heart valves: A numerical evaluation
2011
This study investigates the hemodynamics of aortic heart valves under normal conditions as well as two severe diseases, which would be fundamentals for an assessment of mechanical behaviors of polyurethane (PU) prosthetic heart valves. Analysis results highlight that leaflet opening situation and valve geometry affect the shear stress distribution and vortex flow regime. The interactive impact between low and high wall shear stress on relation to heart valve diseases have been also demonstrated. The results show that low density PU material achieves good hydrodynamic function but produces high stress, while high density PU resists motion of leaflet but reduces the stress significantly. This study also proves that low Young's modulus PU leaflets achieve good hydrodynamic function while reducing the stress exerted upon the leaflets, and vice versa for high Young's modulus.
Effect of Specimen Size and Aspect Ratio on the Tensile Properties of Porcine Aortic Valve Tissues
Annals of Biomedical Engineering, 2000
The measurement of mechanical properties of biological tissues is subject to artifacts such as natural variability and inconsistency in specimen preparation. As a result, data cannot be easily compared across laboratories. To test the effects of variable specimen dimensions, we systematically modified the size and aspect ratio ͑AR͒ of porcine aortic valve tissues and measured their stiffness and extensibility. We found that: ͑i͒ as the AR of circumferential specimens increased from 1:1 to 5:1, their stiffness increased by 36% (pϽ0.001) and their extensibility decreased by 21% (pϽ0.001); ͑ii͒ as the AR of radial specimens increased from 0.8:1 to 4:1, their stiffness increased by 36% (pϽ0.001) and their extensibility decreased by 34% (pϽ0.001); ͑iii͒ as the size of circumferential specimens was reduced from 128 to 32 mm 2 at fixed AR ͑2:1͒, their stiffness decreased by 6% (pϭ0.05), and their extensibility increased by 17% (pϽ0.001); and ͑iv͒ as the size of radial specimens was reduced from 72 to 32 mm 2 at fixed AR ͑2:1͒, their stiffness decreased by 7% (pϭ0.03) and their extensibility increased by 16% (pϭ0.005). Thus, as specimens of constant length became narrower, they became stiffer and less extensible, and as specimens of fixed aspect ratio became smaller, they became less stiff and more extensible. Statistical models of these trends were predictive and can thus be used to integrate materials test data across different laboratories.