Lee Aeryne, Liu Xinying, Giaretta Jacopo Emilio, Hoang Thanh Phuong, Crago Matthew, Farajikhah Syamak, Mosse Luke, Fletcher David Frederick, Dehghani Fariba, Winlaw David Scott, Naficy Sina
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia.
School of Medicine, The University of Sydney, Camperdown, Australia.
JTCVS Open. 2023 Jul 17;15:113-124. doi: 10.1016/j.xjon.2023.06.020. eCollection 2023 Sep.
Polymeric heart valves (PHVs) may address the limitations of mechanical and tissue valves in the treatment of valvular heart disease. In this study, a bioinspired valve was designed, assessed in silico, and validated by an in vitro model to develop a valve with optimum function for pediatric applications.
A bioinspired heart valve was created computationally with leaflet curvature derived from native valve anatomies. A valve diameter of 18 mm was chosen to approach sizes suitable for younger patients. Valves of different thicknesses were fabricated via dip-coating with siloxane-based polyurethane and tested in a pulse duplicator for their hydrodynamic function. The same valves were tested computationally using an arbitrary Lagrangian-Eulerian plus immersed solid approach, in which the fluid-structure interaction between the valves and fluid passing through them was studied and compared with experimental data.
Computational analysis showed that valves of 110 to 200 μm thickness had effective orifice areas (EOAs) of 1.20 to 1.30 cm, with thinner valves exhibiting larger openings. In vitro tests demonstrated that PHVs of similar thickness had EOAs of 1.05 to 1.35 cm and regurgitant fractions (RFs) <7%. Valves with thinner leaflets exhibited optimal systolic performance, whereas thicker valves had lower RFs.
Bioinspired PHVs demonstrated good hydrodynamic performance that exceeded ISO 5840-2 standards. Both methods of analysis showed similar correlations between leaflet thickness and valve systolic function. Further development of this PHV may lead to enhanced durability and thus a more reliable heart valve replacement than contemporary options.
聚合物心脏瓣膜（PHV）可能解决机械瓣膜和组织瓣膜在治疗心脏瓣膜疾病方面的局限性。在本研究中，设计了一种受生物启发的瓣膜，通过计算机模拟进行评估，并通过体外模型进行验证，以开发一种具有最佳功能的儿科应用瓣膜。
通过计算创建了一种受生物启发的心脏瓣膜，其瓣叶曲率源自天然瓣膜解剖结构。选择18毫米的瓣膜直径以接近适合年轻患者的尺寸。通过用硅氧烷基聚氨酯进行浸涂制造不同厚度的瓣膜，并在脉冲复制器中测试其流体动力学功能。使用任意拉格朗日 - 欧拉法加浸入固体法对相同的瓣膜进行计算测试，研究瓣膜与通过它们的流体之间的流固相互作用，并与实验数据进行比较。
计算分析表明，厚度为110至200μm的瓣膜有效开口面积（EOA）为1.20至1.30平方厘米，较薄的瓣膜开口较大。体外测试表明，类似厚度的PHV的EOA为1.05至1.35平方厘米，反流分数（RF）<7％。瓣叶较薄的瓣膜表现出最佳的收缩期性能，而较厚的瓣膜RF较低。
受生物启发的PHV表现出良好的流体动力学性能，超过了ISO 5840 - 2标准。两种分析方法均显示瓣叶厚度与瓣膜收缩期功能之间具有相似的相关性。这种PHV的进一步开发可能会提高耐用性，从而提供比当代选择更可靠的心脏瓣膜置换物。
