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Evaluation of explanted polyurethane trileaflet cardiac valve prostheses.

S L Hilbert, V J Ferrans, Y Tomita

    The Journal of Thoracic and Cardiovascular Surgery
    |September 1, 1987
    PubMed
    Summary

    Prototype polyurethane cardiac valves showed significant calcification after implantation in sheep. This led to valve dysfunction, causing stenosis and regurgitation, impacting hemodynamic performance.

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    Area of Science:

    • Biomaterials Science
    • Cardiovascular Research
    • Medical Device Engineering

    Background:

    • Polyurethane trileaflet cardiac valve prostheses are investigated for long-term implantation.
    • Understanding the degradation and calcification of biomaterials is crucial for device longevity.

    Purpose of the Study:

    • To evaluate the morphologic, chemical, and hemodynamic characteristics of prototype polyurethane cardiac valve prostheses.
    • To identify the primary failure mechanism in mitral valve prostheses implanted in juvenile sheep.

    Main Methods:

    • Morphologic examination of explanted polyurethane trileaflet cardiac valve prostheses.
    • Quantitative chemical analysis for calcium content in leaflet tissues.
    • Hemodynamic performance assessment of implanted cardiac valves.

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    Main Results:

    • Principal finding was significant calcification of polyurethane leaflet surfaces.
    • Quantitative analysis showed a mean calcium value of 42.7 +/- 21 mg/gm dry weight.
    • Two distinct calcification patterns observed: surface-associated and cell-associated within thrombotic material.

    Conclusions:

    • Calcification of polyurethane leaflets is a primary failure mode for these cardiac valve prostheses.
    • Observed calcification patterns correlate with observed hemodynamic dysfunction.
    • Further research is needed to mitigate calcification and improve the durability of polyurethane cardiac valves.