Design and evaluation of valve interventions using ex vivo biomechanical modeling: the Stanford experience

The increase in prevalence of valvular heart disease coupled with an aging population has placed increased emphasis on durable valvular repair strategies. Despite many advances in valvular therapies, there has been little rigorous biomechanical evaluation and validation of existing repair strategies. Our research group engineered a novel 3D-printed, ex vivo heart simulator, which has allowed us to refine and innovate numerous surgical repair strategies with hemodynamic and biomechanical feedback in real time on explanted animal heart valves. Data obtained from this novel simulator have directly influenced clinical practice at our institution. It has also proven to be an outstanding platform for valvular device development. Herein, we will review our experience with ex vivo biomechanical simulation, subdivided into work on aortic valve pathology, mitral valve pathology, and novel devices.