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聚乙烯醇(PVA)冷冻凝胶三叶心脏瓣膜假体的设计与制造。

Design and manufacture of a polyvinyl alcohol (PVA) cryogel tri-leaflet heart valve prosthesis.

作者信息

Jiang Hongjun, Campbell Gord, Boughner Derek, Wan Wan-Kei, Quantz Mackenzie

机构信息

National Research Council of Canada, Integrated Manufacturing Technologies Institute, London, Ontario, Canada N6G 4X8.

出版信息

Med Eng Phys. 2004 May;26(4):269-77. doi: 10.1016/j.medengphy.2003.10.007.

Abstract

Although current artificial heart valves are life sustaining medical devices, improvements are still necessary to address deficiencies. Bioprosthetic valves have a compromised fatigue life, while mechanical valves have better durability but are prone to thromboembolic complications. A novel, one-piece, tricuspid valve, consisting of leaflets, stent and sewing ring, made entirely from the hydrogel, polyvinyl alcohol cryogel (PVA-C), has been developed and demonstrated. This valve has three thin leaflets attached to a cylindrical stent. In order to approximate the complex shape of the surface of the natural heart valve leaflets, two different geometries have been proposed: revolution about an axis of a hyperboloid shape and revolution about an axis of an arc subtending (joining) two straight lines. The parameters of both geometries were examined based on a compromise between avoiding sharp curvature of leaflets and minimization of the central opening of the valve when closed. The revolution of an arc subtending two straight lines was selected as the preferred geometry since it has the benefit of a smaller central opening when the value of the maximum curvature for the leaflets is the same for each valve geometry. A cavity mold has been designed and constructed to form the PVA-C heart valve. The three leaflets were formed and integrated into the stent and sewing ring in a single process. Prototype heart valves were manufactured in the mold from a solution of PVA and water, by controlled freezing and thawing cycles.

摘要

尽管目前的人工心脏瓣膜是维持生命的医疗设备,但仍有必要进行改进以解决不足之处。生物瓣膜的疲劳寿命有限,而机械瓣膜虽然耐久性更好,但容易出现血栓栓塞并发症。一种新型的一体式三尖瓣已被开发并展示,它由瓣叶、支架和缝合环组成,完全由水凝胶聚乙烯醇冷冻凝胶(PVA-C)制成。该瓣膜有三个薄瓣叶连接到一个圆柱形支架上。为了近似天然心脏瓣膜瓣叶表面的复杂形状,提出了两种不同的几何形状:绕双曲线形状的轴旋转和绕连接两条直线的弧的轴旋转。基于避免瓣叶出现急剧曲率和关闭时瓣膜中心开口最小化之间的折衷,对这两种几何形状的参数进行了研究。选择绕连接两条直线的弧旋转作为首选几何形状,因为当每种瓣膜几何形状的瓣叶最大曲率值相同时,它具有较小的中心开口。已经设计并制造了一个型腔模具来成型PVA-C心脏瓣膜。三个瓣叶在一个过程中成型并集成到支架和缝合环中。通过控制冷冻和解冻循环,在模具中由PVA和水的溶液制造出原型心脏瓣膜。

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