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Mechanical considerations for polymeric heart valve development: Biomechanics, materials, design and manufacturing.

Authors
  • Li, Richard L1
  • Russ, Jonathan2
  • Paschalides, Costas3
  • Ferrari, Giovanni4
  • Waisman, Haim2
  • Kysar, Jeffrey W5
  • Kalfa, David6
  • 1 Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA; Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA.
  • 2 Department of Civil Engineering and Engineering Mechanics, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA.
  • 3 Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA.
  • 4 Department of Surgery and Biomedical Engineering, Columbia University Medical Center, New York, NY, USA.
  • 5 Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA; Department of Otolaryngology - Head and Neck Surgery, Columbia University Medical Center, New York, NY, USA. Electronic address: [email protected]
  • 6 Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA. Electronic address: [email protected]
Type
Published Article
Journal
Biomaterials
Publication Date
Dec 01, 2019
Volume
225
Pages
119493–119493
Identifiers
DOI: 10.1016/j.biomaterials.2019.119493
PMID: 31569017
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The native human heart valve leaflet contains a layered microstructure comprising a hierarchical arrangement of collagen, elastin, proteoglycans and various cell types. Here, we review the various experimental methods that have been employed to probe this intricate microstructure and which attempt to elucidate the mechanisms that govern the leaflet's mechanical properties. These methods include uniaxial, biaxial, and flexural tests, coupled with microstructural characterization techniques such as small angle X-ray scattering (SAXS), small angle light scattering (SALS), and polarized light microscopy. These experiments have revealed complex elastic and viscoelastic mechanisms that are highly directional and dependent upon loading conditions and biochemistry. Of all engineering materials, polymers and polymer-based composites are best able to mimic the tissue-level mechanical behavior of the native leaflet. This similarity to native tissue permits the fabrication of polymeric valves with physiological flow patterns, reducing the risk of thrombosis compared to mechanical valves and in some cases surpassing the in vivo durability of bioprosthetic valves. Earlier work on polymeric valves simply assumed the mechanical properties of the polymer material to be linear elastic, while more recent studies have considered the full hyperelastic stress-strain response. These material models have been incorporated into computational models for the optimization of valve geometry, with the goal of minimizing internal stresses and improving durability. The latter portion of this review recounts these developments in polymeric heart valves, with a focus on mechanical testing of polymers, valve geometry, and manufacturing methods. Copyright © 2019 Elsevier Ltd. All rights reserved.

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