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Leaflet geometry and function in porcine bioprostheses.

M Butterfield1, J Fisher, G A Davies

  • 1Cardiac Research Unit, Killingbeck Hospital, Leeds, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1991
PubMed
Summary
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Bioprosthetic valve leaflet geometry is altered during fixation and mounting, leading to increased bending strains. These strains may contribute to tissue degeneration and calcification in bioprosthetic heart valves.

Area of Science:

  • Biomaterials Science
  • Cardiovascular Engineering
  • Medical Device Research

Background:

  • Porcine bioprosthetic heart valves are widely used but can undergo tissue degeneration.
  • Leaflet geometry and hydrodynamic function are critical for bioprosthetic valve performance.
  • Fixation and mounting processes may alter native leaflet geometry.

Purpose of the Study:

  • To compare the leaflet geometry and hydrodynamic function of five commercial porcine bioprostheses to a fresh tissue porcine valve.
  • To investigate how fixation and mounting procedures affect leaflet geometry.
  • To identify potential causes of tissue degeneration in bioprosthetic valves.

Main Methods:

  • Geometric analysis of leaflet configurations in four bioprosthetic valves (two high-pressure fixed, two low-pressure fixed) and one fresh tissue valve.

Related Experiment Videos

  • Hydrodynamic testing to assess leaflet function under simulated physiological conditions.
  • Measurement of leaflet bending strains, particularly in the commissural region.

    • Main Results:

    • Fixation and mounting modified leaflet geometry in bioprosthetic valves, increasing the ratio of leaflet length to valve spacing compared to fresh tissue valves.
    • These geometrical changes resulted in higher bending strains in the commissural area of open leaflets during hydrodynamic tests.
    • Leaflet opening at low flow rates was influenced by leaflet geometry.
    • The fresh tissue valve exhibited a cylindrical shell geometry with reduced open leaflet bending strains.

    Conclusions:

    • Geometrical alterations during bioprosthetic valve manufacturing induce higher bending strains.
    • Increased bending strains in the commissural region may be a key factor in subsequent tissue degeneration and calcification.
    • Optimizing fixation and mounting processes could potentially improve the durability of bioprosthetic heart valves.