{"title":"Can mechanical heart valves perform similarly to tissue valves? An in vitro study","authors":"","doi":"10.1016/j.jbiomech.2024.112270","DOIUrl":null,"url":null,"abstract":"<div><p>Current surgical aortic valve (AV) replacement options include bioprosthetic and mechanical heart valves (MHVs), each with inherent limitations. Bioprosthetic valves offer superior hemodynamics but suffer from durability issues, typically initiating deterioration within 7–8 years. MHVs, while durable, necessitate lifelong anticoagulation therapy, presenting risks such as severe bleeding and thromboembolic events. The need for anticoagulants is caused by non-physiological flow through the hinge area during the closed phase and large spikes of regional backflow velocity (RBV) during the closing phase that produces high shear events. This study introduces the iValve, a novel MHV designed to combine the hemodynamic benefits of bioprosthetic valves with the durability of MHVs without requiring anticoagulation. The iValve features eye-like leaflets, a saddle-shaped housing, and an optimized hinge design to enhance blood flow and minimize thrombotic risk. Fabricated using 6061-T6 aluminum and polyether ether ketone (PEEK), twelve iValve iterations were evaluated for their opening and closing dynamics. The reported top-performing prototypes demonstrated competitive performance against industry standards. The proposed iValve prototype exhibited a mean RBV of −4.34 m/s with no spikes in RBV, performing similarly to bioprosthetic valves and significantly outperforming existing MHVs. The iValve’s optimized design showed a 7–10% reduction in closing time and a substantial decrease in RBV spikes, potentially reducing the need for anticoagulation therapy. This study highlights the iValve’s potential to revolutionize prosthetic heart valve technology by offering a durable, hemodynamically superior solution that mitigates the drawbacks of current MHVs.</p></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021929024003488/pdfft?md5=58b7d2db86a9ce7c9ca2ab84e3bc6615&pid=1-s2.0-S0021929024003488-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0021929024003488","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BIOPHYSICS","Score":null,"Total":0}
引用次数: 0
Abstract
Current surgical aortic valve (AV) replacement options include bioprosthetic and mechanical heart valves (MHVs), each with inherent limitations. Bioprosthetic valves offer superior hemodynamics but suffer from durability issues, typically initiating deterioration within 7–8 years. MHVs, while durable, necessitate lifelong anticoagulation therapy, presenting risks such as severe bleeding and thromboembolic events. The need for anticoagulants is caused by non-physiological flow through the hinge area during the closed phase and large spikes of regional backflow velocity (RBV) during the closing phase that produces high shear events. This study introduces the iValve, a novel MHV designed to combine the hemodynamic benefits of bioprosthetic valves with the durability of MHVs without requiring anticoagulation. The iValve features eye-like leaflets, a saddle-shaped housing, and an optimized hinge design to enhance blood flow and minimize thrombotic risk. Fabricated using 6061-T6 aluminum and polyether ether ketone (PEEK), twelve iValve iterations were evaluated for their opening and closing dynamics. The reported top-performing prototypes demonstrated competitive performance against industry standards. The proposed iValve prototype exhibited a mean RBV of −4.34 m/s with no spikes in RBV, performing similarly to bioprosthetic valves and significantly outperforming existing MHVs. The iValve’s optimized design showed a 7–10% reduction in closing time and a substantial decrease in RBV spikes, potentially reducing the need for anticoagulation therapy. This study highlights the iValve’s potential to revolutionize prosthetic heart valve technology by offering a durable, hemodynamically superior solution that mitigates the drawbacks of current MHVs.
期刊介绍:
The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership.
Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to:
-Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells.
-Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions.
-Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response.
-Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing.
-Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine.
-Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction.
-Molecular Biomechanics - Mechanical analyses of biomolecules.
-Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints.
-Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics.
-Sports Biomechanics - Mechanical analyses of sports performance.