Leaflet Mechanical Properties of Carpentier-Edwards Perimount Magna Pericardial Aortic Bioprostheses. 2017

Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
Department of Surgery, University of California at San Francisco Medical Center and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.

BACKGROUND Transcatheter aortic valve replacement (TAVR) has recently been shown to be equivalent to surgical aortic valve replacement (SAVR) in intermediate-risk patients. As TAVR expands towards the traditionally SAVR population, TAVR versus SAVR durability becomes increasingly important. While the durability of TAVR is unknown, valve design - particularly with regards to leaflet stress - impacts on valve durability. Although leaflet stress cannot be measured directly, it can be determined using finite element modeling, with such models requiring the mechanical properties of the leaflets. Balloon-expandable TAVR involves the use of bovine pericardial leaflets treated in the same manner as surgical bioprosthetic leaflets. The study aim was to determine the leaflet mechanical properties of Carpentier-Edwards bioprostheses for future TAVR and SAVR computational models. METHODS A total of 35 leaflets were excised from 12 Carpentier-Edwards Model 3000TFX Perimount Magna aortic bioprostheses (21 mm, 23 mm, and 25 mm) and subjected to displacement-controlled equibiaxial stretch testing. The stress-strain data acquired were fitted to a Fung constitutive model to describe the material properties in circumferential and radial directions. Leaflet stiffness was calculated at specified physiological stress, corresponding to zero pressure, systemic pressure, and between zero and systemic pressure. RESULTS The 21-mm bioprostheses had significantly thinner leaflets than the larger bioprostheses. A non-linear stress-strain relationship was observed in all leaflets along the circumferential and radial directions. No significant difference in leaflet stiffness at systemic pressure, or between zero and systemic pressure, was found among the three bioprosthesis sizes. However, the leaflets from the 23 mm bioprosthesis were significantly more compliant than those of the 21 mm and 25 mm bioprostheses at zero pressure in the circumferential direction. No differences were observed in leaflet stiffness in circumferential versus radial directions. CONCLUSIONS The bovine pericardial leaflets from Carpentier-Edwards Perimount Magna bioprostheses showed no differences in material properties among different valve sizes at systemic pressure. The thinner 21 mm leaflets did not show any corresponding differences in leaflet stiffness, which suggests that the thinner TAV leaflets may have a similar stiffness to their thicker SAV counterparts.

UI MeSH Term Description Entries
D011474 Prosthesis Design The plan and delineation of prostheses in general or a specific prosthesis. Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D002417 Cattle Domesticated bovine animals of the genus Bos, usually kept on a farm or ranch and used for the production of meat or dairy products or for heavy labor. Beef Cow,Bos grunniens,Bos indicus,Bos indicus Cattle,Bos taurus,Cow,Cow, Domestic,Dairy Cow,Holstein Cow,Indicine Cattle,Taurine Cattle,Taurus Cattle,Yak,Zebu,Beef Cows,Bos indicus Cattles,Cattle, Bos indicus,Cattle, Indicine,Cattle, Taurine,Cattle, Taurus,Cattles, Bos indicus,Cattles, Indicine,Cattles, Taurine,Cattles, Taurus,Cow, Beef,Cow, Dairy,Cow, Holstein,Cows,Dairy Cows,Domestic Cow,Domestic Cows,Indicine Cattles,Taurine Cattles,Taurus Cattles,Yaks,Zebus
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001021 Aortic Valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Aortic Valves,Valve, Aortic,Valves, Aortic
D001705 Bioprosthesis Prosthesis, usually heart valve, composed of biological material and whose durability depends upon the stability of the material after pretreatment, rather than regeneration by host cell ingrowth. Durability is achieved 1, mechanically by the interposition of a cloth, usually polytetrafluoroethylene, between the host and the graft, and 2, chemically by stabilization of the tissue by intermolecular linking, usually with glutaraldehyde, after removal of antigenic components, or the use of reconstituted and restructured biopolymers. Glutaraldehyde-Stabilized Grafts,Heterograft Bioprosthesis,Porcine Xenograft Bioprosthesis,Xenograft Bioprosthesis,Bioprostheses,Bioprostheses, Heterograft,Bioprostheses, Porcine Xenograft,Bioprostheses, Xenograft,Bioprosthesis, Heterograft,Bioprosthesis, Porcine Xenograft,Bioprosthesis, Xenograft,Glutaraldehyde Stabilized Grafts,Glutaraldehyde-Stabilized Graft,Graft, Glutaraldehyde-Stabilized,Grafts, Glutaraldehyde-Stabilized,Heterograft Bioprostheses,Porcine Xenograft Bioprostheses,Xenograft Bioprostheses,Xenograft Bioprostheses, Porcine,Xenograft Bioprosthesis, Porcine
D065467 Transcatheter Aortic Valve Replacement Surgical treatment for severe AORTIC VALVE STENOSIS. Transcatheter aortic valve replacement (TAVR) is used as an alternative option in patients who are deemed at high risk or inoperable for traditional open-heart surgery. Transcatheter Aortic Valve Implantation

Related Publications

Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
June 2018, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
May 2001, The Annals of thoracic surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
July 2012, Journal of medical ultrasonics (2001),
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
January 2011, ASAIO journal (American Society for Artificial Internal Organs : 1992),
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
March 2006, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
December 2015, Interactive cardiovascular and thoracic surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
December 2022, Journal of cardiac surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
December 2005, The Journal of thoracic and cardiovascular surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
August 1999, The Journal of thoracic and cardiovascular surgery,
Heide Kuang, and Yue Xuan, and Michelle Lu, and Aart Mookhoek, and Andrew D Wisneski, and Julius M Guccione, and Liang Ge, and Elaine E Tseng
June 2006, Interactive cardiovascular and thoracic surgery,
Copied contents to your clipboard!