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Armfield D, Boxwell S, McNamara L, Cook S, Conway S, Celikin M, Cardiff P. Effect of bioprosthetic leaflet anisotropy on stent dynamics of Transcatheter Aortic Valve Replacement devices. J Mech Behav Biomed Mater 2024; 157:106650. [PMID: 39018917 DOI: 10.1016/j.jmbbm.2024.106650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/19/2024]
Abstract
The assessment of stent fatigue in Transcatheter Aortic Valve Replacement (TAVR) systems is critical for the design of next-generation devices, both in vitro and in vivo. The mechanical properties of the bioprosthetic heart valves (BHVs) have a significant impact on the fatigue life of the metallic stent and thus must be taken into consideration when evaluating new TAVR device designs. This study aims to investigate the relationship between BHV anisotropic behaviour and the asymmetric deflections of the stent frame observed during in vitro testing. An explicit dynamics finite element model of the nitinol stent with attached bioprosthetic valve leaflets was developed to evaluate the deflections of the TAVR device under haemodynamic loading. Our results demonstrate that pericardium behaviour plays a dominant role in determining stent frame deflection. The anisotropic behaviour of the leaflets, resulting from collagen fibre orientation, affects the extent of deflection encountered by each commissure of the frame. This leads to asymmetric variation in frame deflection that can influence the overall fatigue life of the nitinol stent. This study highlights the importance of considering both the flexible nature of the metallic stent as well as the leaflet anisotropic behaviour in the design and fatigue assessment of TAVR systems.
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Affiliation(s)
- Dylan Armfield
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland; SFI I-Form Centre, University College Dublin, Dublin, Ireland.
| | - Sam Boxwell
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland; Mechanobiology and Medical Device Research Group, Department of Biomedical Engineering, University of Galway, Galway, Ireland
| | - Laoise McNamara
- Mechanobiology and Medical Device Research Group, Department of Biomedical Engineering, University of Galway, Galway, Ireland
| | - Scott Cook
- Structural Heart Division, Boston Scientific Corporation, Galway, Ireland
| | - Shane Conway
- Structural Heart Division, Boston Scientific Corporation, Galway, Ireland
| | - Mert Celikin
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland; SFI I-Form Centre, University College Dublin, Dublin, Ireland
| | - Philip Cardiff
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland; SFI I-Form Centre, University College Dublin, Dublin, Ireland.
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Donmazov S, Piskin S, Gölcez T, Kul D, Arnaz A, Pekkan K. Mechanical characterization and torsional buckling of pediatric cardiovascular materials. Biomech Model Mechanobiol 2024; 23:845-860. [PMID: 38361084 PMCID: PMC11101351 DOI: 10.1007/s10237-023-01809-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/22/2023] [Indexed: 02/17/2024]
Abstract
In complex cardiovascular surgical reconstructions, conduit materials that avoid possible large-scale structural deformations should be considered. A fundamental mode of mechanical complication is torsional buckling which occurs at the anastomosis site due to the mechanical instability, leading surgical conduit/patch surface deformation. The objective of this study is to investigate the torsional buckling behavior of commonly used materials and to develop a practical method for estimating the critical buckling rotation angle under physiological intramural vessel pressures. For this task, mechanical tests of four clinically approved materials, expanded polytetrafluoroethylene (ePTFE), Dacron, porcine and bovine pericardia, commonly used in pediatric cardiovascular surgeries, are conducted (n = 6). Torsional buckling initiation tests with n = 4 for the baseline case (L = 7.5 cm) and n = 3 for the validation of ePTFE (L = 15 cm) and Dacron (L = 15 cm and L = 25 cm) for each are also conducted at low venous pressures. A practical predictive formulation for the buckling potential is proposed using experimental observations and available theory. The relationship between the critical buckling rotation angle and the lumen pressure is determined by balancing the circumferential component of the compressive principal stress with the shear stress generated by the modified critical buckling torque, where the modified critical buckling torque depends linearly on the lumen pressure. While the proposed technique successfully predicted the critical rotation angle values lying within two standard deviations of the mean in the baseline case for all four materials at all lumen pressures, it could reliably predict the critical buckling rotation angles for ePTFE and Dacron samples of length 15 cm with maximum relative errors of 31% and 38%, respectively, in the validation phase. However, the validation of the performance of the technique demonstrated lower accuracy for Dacron samples of length 25 cm at higher pressure levels of 12 mmHg and 15 mmHg. Applicable to all surgical materials, this formulation enables surgeons to assess the torsional buckling potential of vascular conduits noninvasively. Bovine pericardium has been found to exhibit the highest stability, while Dacron (the lowest) and porcine pericardium have been identified as the least stable with the (unitless) torsional buckling resistance constants, 43,800, 12,300 and 14,000, respectively. There was no significant difference between ePTFE and Dacron, and between porcine and bovine pericardia. However, both porcine and bovine pericardia were found to be statistically different from ePTFE and Dacron individually (p < 0.0001). ePTFE exhibited highly nonlinear behavior across the entire strain range [0, 0.1] (or 10% elongation). The significant differences among the surgical materials reported here require special care in conduit construction and anastomosis design.
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Affiliation(s)
- Samir Donmazov
- Department of Mathematics, University of Kentucky, Kentucky, 40506, USA
| | - Senol Piskin
- Department of Mechanical Engineering, Istinye University, Istanbul, 34010, Turkey
| | - Tansu Gölcez
- Department of Bio-Medical Science and Engineering, Koc University, Istanbul, Turkey
| | - Demet Kul
- Department of Cellular and Molecular Medicine, Koc University, Istanbul, Turkey
| | - Ahmet Arnaz
- Department of Cardiovascular Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Kerem Pekkan
- Department of Mechanical Engineering, Koc University, Sariyer, Istanbul, Turkey.
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Recco DP, Kizilski SB, Marshall LE, Earley PD, Kneier NE, del Nido PJ, Hammer PE, Hoganson DM. Mechanical failure analysis of patch materials used in aortic arch reconstruction: implications for clinical practice. Eur J Cardiothorac Surg 2023; 64:ezad366. [PMID: 37897688 PMCID: PMC11005168 DOI: 10.1093/ejcts/ezad366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/17/2023] [Accepted: 10/27/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES Thick-patch pulmonary homograft, autologous pericardium and CardioCel Neo are common patch materials for aortic arch reconstruction. Insufficient data exist on sutured patch strength and limits of use. We evaluated failure strength of these materials to develop a failure prediction model for clinical guidance. METHODS Patch failure strength was evaluated via sutured uniaxial and burst pressure testing. In sutured uniaxial testing, patches were sutured to aortic or Dacron tabs and pulled to failure. In burst pressure testing, patches were sewn into porcine aortas or Dacron grafts and pressurized to failure. Failure membrane tension was calculated. A prediction model of membrane tension versus vessel diameter was generated to guide clinical patch selection. RESULTS Combining sutured uniaxial and burst pressure test data, pulmonary homograft failure strength {0.61 [interquartile range (IQR): 0.44, 0.78] N/mm, n = 21} was less than half that of autologous pericardium [2.22 (IQR: 1.65, 2.78) N/mm, n = 15] and CardioCel Neo [1.31 (IQR: 1.20, 1.42) N/mm, n = 20]. Pulmonary homograft burst pressure [245 (IQR: 202, 343) mmHg, n = 7] was significantly lower than autologous pericardium [863 (IQR: 802, 919) mmHg, n = 6] and CardioCel Neo [766 (IQR: 721, 833) mmHg, n = 6]. Our model predicts failure limits for each patch material and outlines safety margins for combinations of aortic diameter and pressure. CONCLUSIONS Sutured failure strength of thick-patch pulmonary homograft was significantly lower than autologous pericardium and CardioCel Neo. Patient selection (predicted postoperative arch diameter and haemodynamics) and blood pressure management must be considered when choosing patch material for arch reconstruction. In older children and adolescents, autologous or bovine pericardium may be more suitable materials for aortic patch augmentation to minimize the risk of postoperative patch failure.
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Affiliation(s)
- Dominic P Recco
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Shannen B Kizilski
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lauren E Marshall
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
| | - Patrick D Earley
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
| | - Nicholas E Kneier
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
| | - Pedro J del Nido
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Peter E Hammer
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - David M Hoganson
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Danilov VV, Klyshnikov KY, Onishenko PS, Proutski A, Gankin Y, Melgani F, Ovcharenko EA. Perfect prosthetic heart valve: generative design with machine learning, modeling, and optimization. Front Bioeng Biotechnol 2023; 11:1238130. [PMID: 37781537 PMCID: PMC10541217 DOI: 10.3389/fbioe.2023.1238130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Majority of modern techniques for creating and optimizing the geometry of medical devices are based on a combination of computer-aided designs and the utility of the finite element method This approach, however, is limited by the number of geometries that can be investigated and by the time required for design optimization. To address this issue, we propose a generative design approach that combines machine learning (ML) methods and optimization algorithms. We evaluate eight different machine learning methods, including decision tree-based and boosting algorithms, neural networks, and ensembles. For optimal design, we investigate six state-of-the-art optimization algorithms, including Random Search, Tree-structured Parzen Estimator, CMA-ES-based algorithm, Nondominated Sorting Genetic Algorithm, Multiobjective Tree-structured Parzen Estimator, and Quasi-Monte Carlo Algorithm. In our study, we apply the proposed approach to study the generative design of a prosthetic heart valve (PHV). The design constraints of the prosthetic heart valve, including spatial requirements, materials, and manufacturing methods, are used as inputs, and the proposed approach produces a final design and a corresponding score to determine if the design is effective. Extensive testing leads to the conclusion that utilizing a combination of ensemble methods in conjunction with a Tree-structured Parzen Estimator or a Nondominated Sorting Genetic Algorithm is the most effective method in generating new designs with a relatively low error rate. Specifically, the Mean Absolute Percentage Error was found to be 11.8% and 10.2% for lumen and peak stress prediction respectively. Furthermore, it was observed that both optimization techniques result in design scores of approximately 95%. From both a scientific and applied perspective, this approach aims to select the most efficient geometry with given input parameters, which can then be prototyped and used for subsequent in vitro experiments. By proposing this approach, we believe it will replace or complement CAD-FEM-based modeling, thereby accelerating the design process and finding better designs within given constraints. The repository, which contains the essential components of the study, including curated source code, dataset, and trained models, is publicly available at https://github.com/ViacheslavDanilov/generative_design.
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Affiliation(s)
| | - Kirill Y. Klyshnikov
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Pavel S. Onishenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | | | | | | | - Evgeny A. Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
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Zaitsev VY, Sovetsky AA, Matveyev AL, Matveev LA, Shabanov D, Salamatova VY, Karavaikin PA, Vassilevski YV. Application of compression optical coherence elastography for characterization of human pericardium: A pilot study. JOURNAL OF BIOPHOTONICS 2023; 16:e202200253. [PMID: 36397665 DOI: 10.1002/jbio.202200253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/23/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The recent impressive progress in Compression Optical Coherence Elastography (C-OCE) demonstrated diverse biomedical applications, comprising ophthalmology, oncology, etc. High resolution of C-OCE enables spatially resolved characterization of elasticity of rather thin (thickness < 1 mm) samples, which previously was impossible. Besides Young's modulus, C-OCE enables obtaining of nonlinear stress-strain dependences for various tissues. Here, we report the first application of C-OCE to nondestructively characterize biomechanics of human pericardium, for which data of conventional tensile tests are very limited and controversial. C-OCE revealed pronounced differences among differently prepared pericardium samples. Ample understanding of the influence of chemo-mechanical treatment on pericardium biomechanics is very important because of rapidly growing usage of own patients' pericardium for replacement of aortic valve leaflets in cardio-surgery. The figure demonstrates differences in the tangent Young's modulus after glutaraldehyde-induced cross-linking for two pericardium samples. One sample was over-stretched during the preparation, which caused some damage to the tissue.
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Affiliation(s)
- Vladimir Y Zaitsev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander A Sovetsky
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander L Matveyev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Lev A Matveev
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Dmitry Shabanov
- Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Victoria Y Salamatova
- Sechenov University, Moscow, Russia
- Sirius University of Science and Technology, Sochi, Russia
| | | | - Yuri V Vassilevski
- Sechenov University, Moscow, Russia
- Sirius University of Science and Technology, Sochi, Russia
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia
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6
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Rezvova MA, Klyshnikov KY, Gritskevich AA, Ovcharenko EA. Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices. Int J Mol Sci 2023; 24:ijms24043963. [PMID: 36835389 PMCID: PMC9967268 DOI: 10.3390/ijms24043963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
The development of a novel artificial heart valve with outstanding durability and safety has remained a challenge since the first mechanical heart valve entered the market 65 years ago. Recent progress in high-molecular compounds opened new horizons in overcoming major drawbacks of mechanical and tissue heart valves (dysfunction and failure, tissue degradation, calcification, high immunogenic potential, and high risk of thrombosis), providing new insights into the development of an ideal artificial heart valve. Polymeric heart valves can best mimic the tissue-level mechanical behavior of the native valves. This review summarizes the evolution of polymeric heart valves and the state-of-the-art approaches to their development, fabrication, and manufacturing. The review discusses the biocompatibility and durability testing of previously investigated polymeric materials and presents the most recent developments, including the first human clinical trials of LifePolymer. New promising functional polymers, nanocomposite biomaterials, and valve designs are discussed in terms of their potential application in the development of an ideal polymeric heart valve. The superiority and inferiority of nanocomposite and hybrid materials to non-modified polymers are reported. The review proposes several concepts potentially suitable to address the above-mentioned challenges arising in the R&D of polymeric heart valves from the properties, structure, and surface of polymeric materials. Additive manufacturing, nanotechnology, anisotropy control, machine learning, and advanced modeling tools have given the green light to set new directions for polymeric heart valves.
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Affiliation(s)
- Maria A. Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
| | - Kirill Y. Klyshnikov
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
| | | | - Evgeny A. Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
- Correspondence:
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7
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A New Detergent for the Effective Decellularization of Bovine and Porcine Pericardia. Biomimetics (Basel) 2022; 7:biomimetics7030104. [PMID: 35997424 PMCID: PMC9397045 DOI: 10.3390/biomimetics7030104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/10/2022] Open
Abstract
Human and animal pericardia are among the most widely exploited materials suitable to repair damaged tissues in the cardiovascular surgery context. Autologous, xenogeneic (chemically treated) and homologous pericardia are largely utilized, but they do exhibit some crucial drawbacks. Any tissue treated with glutaraldehyde is known to be prone to calcification in vivo, lacks regeneration potential, has limited durability, and can result in cytotoxicity. Moreover, autologous tissues have limited availability. Decellularized biological tissues represent a promising alternative: decellularization removes cellular and nuclear components from native tissues and makes them suitable for repopulation by autologous cells upon implantation into the body. The present work aims to assess the effects of a new detergent, i.e., Tergitol, for decellularizing bovine and porcine pericardia. The decellularization procedure successfully removed cells, while preserving the histoarchitecture of the extracellular matrix. No cytotoxic effect was observed. Therefore, decellularized pericardia showed potential to be used as scaffold for cardiovascular tissue regeneration.
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8
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Rassoli A, Fatouraee N, Guidoin R, Zhang Z, Ravaghi S. A comparative study of different tissue materials for bioprosthetic aortic valves using experimental assays and finite element analysis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 220:106813. [PMID: 35461127 DOI: 10.1016/j.cmpb.2022.106813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/18/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Extracting the mechanical behaviors of bioprosthetic aortic valve leaflets is necessary for the appropriate design and manufacture of the prosthetic valves. The goal of this study was to opt a proper tissue for the valve leaflets by comparing the mechanical properties of the equine, porcine, and donkey pericardia with those of the bovine pericardium and human aortic valve leaflets. METHODS After tissue fixation in glutaraldehyde, the mechanical behaviors of the pericardial tissues were experimentally evaluated through computational methods. The relaxation tests were performed along the tissue fiber direction. The Mooney-Rivlin model was utilized to describe the hyperelastic behavior of the tissues at the ramp portion. The viscous behaviors at the hold portion were extracted using the Fung quasi-linear viscoelastic (QLV) model. Furthermore, the extracted parameters were used in the modeling of the bovine, equine, porcine, and donkey pericardia through finite element analysis (FEA). RESULTS Based on the results, relaxation percentages of the equine, donkey, and bovine pericardia were greater than that of the porcine pericardium and similar to the native human aortic valve leaflets. Indeed, the equine and donkey pericardia were found more viscous and less elastic than the porcine pericardium. Compared with the porcine pericardium, the mechanical properties of the equine and donkey pericardia were rather closer to those of the native human leaflets and bovine pericardium. The computational analysis demonstrated that the donkey pericardium is preferable over other types of pericardium due to the low stress on the leaflets during the systolic and diastolic phases and the large geometric orifice area (GOA). CONCLUSION The donkey pericardium might be a good candidate valve leaflet material for bioprosthetic aortic valves.
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Affiliation(s)
- Aisa Rassoli
- Department of Mechanical Engineering, K.N. Toosi University of Technology, Tehran, Iran; Department of Surgery, Faculty of Medicine, Université Laval and Centre de Recherche du CHU, Quebec, Canada
| | - Nasser Fatouraee
- Biological Fluid Mechanics Research Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), P.O. Box: 15875-3413, Tehran, Iran.
| | - Robert Guidoin
- Department of Surgery, Faculty of Medicine, Université Laval and Centre de Recherche du CHU, Quebec, Canada
| | - Ze Zhang
- Department of Surgery, Faculty of Medicine, Université Laval and Centre de Recherche du CHU, Quebec, Canada
| | - Saba Ravaghi
- Mechanical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
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9
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Influence of inflammation and cardiac hypertrophy on mechanical properties of human pericardium. Proc Inst Mech Eng H 2022; 236:730-739. [DOI: 10.1177/09544119221077739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Different devices for mechanical circulatory support (MCS) have been developed for the treatment of refractory cardiogenic shock. However, all of them are associated with direct blood contact, the need for anticoagulation and bleeding complications. To overcome these limitations the pericardial sac got into the focus as a promising implantation site for MCS. For this purpose, further knowledge about the mechanical properties of human pericardium is required. In this prospective, monocentric, experimental pilot study 56 samples of human pericardium were extracted postmortem from 13 critically ill patients. After preparation of test specimens uniaxial tensile tests were performed. The primary end points were load at fracture per sample width and strain at fracture. Acute inflammation was assessed by blood levels of C-reactive protein, white blood count and procalcitonin measured at several times during hospital stay. Inflammatory load was estimated by area under the inflammatory curves. Correlation and regression analysis were used to assess the relationship of primary end points to inflammation, comorbidities and postmortem time to preparation. Human pericardium showed a load at fracture per sample width of 1.95 [1.38–2.94] N/mm (median [inter quartile range]) and a strain at fracture of 89.29 [73.84–135.23] %. Markers of acute inflammation and cardiac hypertrophy did not correlate to load or strain at fracture. However, strain at fracture increased with higher body mass index and an increasing number of postmortem days. In contrast, higher patient age was associated with a lower strain at fracture. Inflammation and cardiac hypertrophy did not influence mechanical properties of human pericardium.
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10
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Todros S, Barbon S, Stocco E, Favaron M, Macchi V, De Caro R, Porzionato A, Pavan PG. Time-dependent mechanical behavior of partially oxidized polyvinyl alcohol hydrogels for tissue engineering. J Mech Behav Biomed Mater 2021; 125:104966. [PMID: 34798532 DOI: 10.1016/j.jmbbm.2021.104966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 07/26/2021] [Accepted: 11/07/2021] [Indexed: 02/06/2023]
Abstract
Polyvinyl alcohol (PVA) hydrogels are synthetic polymers which can be used as scaffolds for tissue engineering due to their biocompatibility and large water content. To improve their biodegradation properties, partial oxidation of PVA is achieved by means of different oxidizing agents, such as potassium permanganate, bromine and iodine. The effect of this process on hydrogels mechanical performance has not been fully investigated in view of tissue engineering applications. In this work, the time-dependent mechanical behavior of unmodified and partially oxidized PVA hydrogels is evaluated by means of uniaxial tensile and stress relaxation tests, to evaluate the effect of different oxidizing agents on the viscoelastic response. Tensile tests show an isotropic and almost-incompressible behavior, with a stiffness reduction after PVA oxidation. The time-dependent response of oxidized PVA is comparable to the one of unmodified PVA and is modeled as a quasi-linear viscoelastic behavior. Finite Element (FE) models of PVA samples are developed and numerical analyses are used to evaluate the effect of different strain rates on the mechanical response under uniaxial tension. This model can be exploited to predict the time-dependent mechanical behavior of partially oxidized PVA in tissue engineering application under tensile loading.
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Affiliation(s)
- Silvia Todros
- Department of Industrial Engineering, University of Padova, Via Venezia 1, 35131, Padova, Italy; Centre for Mechanics of Biological Materials, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy.
| | - Silvia Barbon
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy
| | - Elena Stocco
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy
| | - Martina Favaron
- Department of Industrial Engineering, University of Padova, Via Venezia 1, 35131, Padova, Italy
| | - Veronica Macchi
- Centre for Mechanics of Biological Materials, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy; Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy
| | - Raffaele De Caro
- Centre for Mechanics of Biological Materials, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy; Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy
| | - Andrea Porzionato
- Centre for Mechanics of Biological Materials, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy; Department of Neurosciences, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121, Padova, Italy
| | - Piero G Pavan
- Department of Industrial Engineering, University of Padova, Via Venezia 1, 35131, Padova, Italy; Centre for Mechanics of Biological Materials, University of Padova, Via F. Marzolo 9, 35131, Padova, Italy; Fondazione Istituto di Ricerca Pediatrica Città Della Speranza, Corso Stati Uniti 4, 35127, Padova, Italy
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11
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Immobilization of amikacin on dextran: biocomposite materials that release an antibiotic in the presence of bacterial dextranase. POLYM INT 2021. [DOI: 10.1002/pi.6171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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12
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Dal Sasso E, Zamuner A, Filippi A, Romanato F, Palmosi T, Vedovelli L, Gregori D, Gómez Ribelles JL, Russo T, Gloria A, Iop L, Gerosa G, Dettin M. Covalent functionalization of decellularized tissues accelerates endothelialization. Bioact Mater 2021; 6:3851-3864. [PMID: 33937589 PMCID: PMC8065253 DOI: 10.1016/j.bioactmat.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022] Open
Abstract
In the field of tissue regeneration, the lack of a stable endothelial lining may affect the hemocompatibility of both synthetic and biological replacements. These drawbacks might be prevented by specific biomaterial functionalization to induce selective endothelial cell (EC) adhesion. Decellularized bovine pericardia and porcine aortas were selectively functionalized with a REDV tetrapeptide at 10−5 M and 10−6 M working concentrations. The scaffold-bound peptide was quantified and REDV potential EC adhesion enhancement was evaluated in vitro by static seeding of human umbilical vein ECs. The viable cells and MTS production were statistically higher in functionalized tissues than in control. Scaffold histoarchitecture, geometrical features, and mechanical properties were unaffected by peptide anchoring. The selective immobilization of REDV was effective in accelerating ECs adhesion while promoting proliferation in functionalized decellularized tissues intended for blood-contacting applications. Covalent functionalization of the decellularized tissues with REDV peptide accelerates endothelialization. New covalent grafting method not inducing collagen cross-linking. Measurements through two photon miscroscopy allow the quantification of biological matrix bound peptide. The decellularized tissues can be changed by chemical procedures to promote specific cellular behaviour with ECM preservation.
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Affiliation(s)
- Eleonora Dal Sasso
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - Annj Zamuner
- Department of Industrial Engineering, University of Padua, Padua, Italy.,LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy
| | - Andrea Filippi
- LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy.,Department of Physics and Astronomy "G. Galilei", University of Padua, Padua, Italy.,Fondazione Bruno Kessler, Trento, Italy.,Institute of Pediatric Research Città della Speranza, Padua, Italy
| | - Filippo Romanato
- LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy.,Department of Physics and Astronomy "G. Galilei", University of Padua, Padua, Italy.,Institute of Pediatric Research Città della Speranza, Padua, Italy
| | - Tiziana Palmosi
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - Luca Vedovelli
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy
| | - José Luís Gómez Ribelles
- Center for Biomaterials and Tissue Engineering, CBIT, Universitat Politècnica de València, València, Spain.,Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valencia, Spain
| | - Teresa Russo
- Institute of Polymers, Composites and Biomaterials, National Research Council of Italy, Naples, Italy
| | - Antonio Gloria
- Institute of Polymers, Composites and Biomaterials, National Research Council of Italy, Naples, Italy
| | - Laura Iop
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy.,LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences and Venetian Institute of Molecular Medicine, Padua, Italy.,LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy
| | - Monica Dettin
- Department of Industrial Engineering, University of Padua, Padua, Italy.,LIFELAB Program, Consorzio per la Ricerca Sanitaria, CORIS, Veneto Region, Italy
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13
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Tuladhar SR, Mulderrig S, Della Barbera M, Vedovelli L, Bottigliengo D, Tessari C, Jockenhoevel S, Gregori D, Thiene G, Korossis S, Mela P, Iop L, Gerosa G. Bioengineered percutaneous heart valves for transcatheter aortic valve replacement: a comparative evaluation of decellularised bovine and porcine pericardia. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:111936. [PMID: 33812574 DOI: 10.1016/j.msec.2021.111936] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/06/2020] [Accepted: 01/31/2021] [Indexed: 12/18/2022]
Abstract
Glutaraldehyde-treated, surgical bioprosthetic heart valves undergo structural degeneration within 10-15 years of implantation. Analogous preliminary results were disclosed for percutaneous heart valves (PHVs) realized with similarly-treated tissues. To improve long-term performance, decellularised scaffolds can be proposed as alternative fabricating biomaterials. The aim of this study was to evaluate whether bovine and porcine decellularised pericardia could be utilised to manufacture bioengineered percutaneous heart valves (bioPHVs) with adequate hydrodynamic performance and leaflet resistance to crimping damage. BioPHVs were fabricated by mounting acellular pericardia onto commercial stents. Independently from the pericardial species used for valve fabrication, bioPHVs satisfied the minimum hydrodynamic performance criteria set by ISO 5840-3 standards and were able to withstand a large spectrum of cardiac output conditions, also during extreme backpressure, without severe regurgitation, especially in the case of the porcine group. No macroscopic or microscopic leaflet damage was detected following bioPHV crimping. Bovine and porcine decellularized pericardia are both suitable alternatives to glutaraldehyde-treated tissues. Between the two types of pericardial species tested, the porcine tissue scaffold might be preferable to fabricate advanced PHV replacements for long-term performance. CONDENSED ABSTRACT: Current percutaneous heart valve replacements are formulated with glutaraldehyde-treated animal tissues, prone to structural degeneration. In order to improve long-term performance, bovine and porcine decellularised pericardia were utilised to manufacture bioengineered replacements, which demonstrated adequate hydrodynamic behaviour and resistance to crimping without leaflet architectural alteration.
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Affiliation(s)
- Sugat Ratna Tuladhar
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Shane Mulderrig
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Mila Della Barbera
- Cardiovascular Pathology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Daniele Bottigliengo
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Tessari
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Dario Gregori
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gaetano Thiene
- Cardiovascular Pathology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Sotiris Korossis
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany; Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Hannover Medical School, Hannover, Germany
| | - Petra Mela
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Laura Iop
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy; L.I.F.E.LA.B., CORIS, Veneto Region, Padua, Italy
| | - Gino Gerosa
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy; L.I.F.E.LA.B., CORIS, Veneto Region, Padua, Italy.
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14
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Schlachtenberger G, Doerr F, Brezina A, Menghesha H, Heldwein MB, Bennink G, Menger MD, Moussavian M, Hekmat K, Wahlers T. Perigraft reaction and incorporation of porcine and bovine pericardial patches. Interact Cardiovasc Thorac Surg 2020; 32:638-647. [PMID: 33313856 DOI: 10.1093/icvts/ivaa308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/21/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Bovine and porcine pericardial patches are frequently used in cardiothoracic and vascular surgery. There are no guidelines recommending the usage of these patches for particular surgical approaches. However, these 2 materials supposedly possess different properties. The clinical advantage of porcine compared with bovine patches remains controversial. In this experimental study, we analysed the incorporation and vascularization of bovine and porcine pericardial patches during the initial phase after implantation. METHODS Bovine and porcine pericardial patches were implanted into the dorsal skinfold chamber of C57BL/6 mice (n = 8 per group) to study vascularization and inflammation at the implantation site using repetitive intravital fluorescence microscopy over a 14-day period. At the end of the in vivo experiments, CD-31-positive cells were determined to evaluate the vascularization by immunohistochemistry. Furthermore, cell proliferation and apoptosis were analysed immunohistochemically. RESULTS Implanted bovine patches exhibited an enhanced vascularization, as indicated by a significantly higher number of CD-31-positive cells and micro-vessels (23.2 ± 4.3 vs 16.5 ± 5.8 mm-2; P = 0.001). Furthermore, bovine patches showed a slightly but not significantly higher functional capillary density. Both patches induced a moderate leukocytic inflammatory host tissue response, and neither bovine nor porcine patches significantly affected apoptosis and cell proliferation at the implantation site. CONCLUSIONS Bovine and porcine pericardial patches are similarly suitable for surgery. Bovine patches exhibited an improved vascularization during the first 14 days after implantation. This may result in a quicker and improved incorporation into the surrounding tissue compared with porcine pericardial patches.
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Affiliation(s)
| | - Fabian Doerr
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Annamaria Brezina
- Department of Anesthesiology and Intensive Care Medicine, Kerpenerstr 62, 50937 Cologne, Germany.,Institute for Clinical and Experimental Surgery, Saarland University Kirberger Strasse, 66421 Homburg/Saar, Germany
| | - Hruy Menghesha
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Matthias B Heldwein
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Gerardus Bennink
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University Kirberger Strasse, 66421 Homburg/Saar, Germany
| | - Mohammed Moussavian
- Department of Surgery, Centre Hospitalier Emile Mayrisch (CHEM), Esch-sur-Alzette, Luxembourg
| | - Khosro Hekmat
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
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15
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Robinson TM, Talebian S, Foroughi J, Yue Z, Fay CD, Wallace GG. Fabrication of Aligned Biomimetic Gellan Gum-Chitosan Microstructures through 3D Printed Microfluidic Channels and Multiple In Situ Cross-Linking Mechanisms. ACS Biomater Sci Eng 2020; 6:3638-3648. [PMID: 33463177 DOI: 10.1021/acsbiomaterials.0c00260] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In this study we use a combination of ionic- and photo-cross-linking to develop a fabrication method for producing biocompatible microstructures using a methacrylated gellan gum (a polyanion) and chitosan (a polycation) in addition to lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) as the photoinitiator. This work involves the development of a low-cost, portable 3D bioprinter and a customized extrusion mechanism for controlled introduction of the materials through a 3D printed microfluidic nozzle, before being cross-linked in situ to form robust microstructure bundles. The formed microstructures yielded a diameter of less than 1 μm and a tensile strength range of ∼1 MPa. This study is the first to explore and achieve GGMA:CHT microstructure fabrication by means of controlled in-line compaction and photo-cross-linking through 3D printed microfluidic channels.
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Affiliation(s)
- Thomas M Robinson
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia
| | - Sepehr Talebian
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia.,Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW 2522, Australia
| | - Javad Foroughi
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia.,School of Electrical, Computer and Telecommunications Engineering, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Zhilian Yue
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia
| | - Cormac D Fay
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia.,SMART Infrastructure Facility, Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Gordon G Wallace
- Intelligent Polymer Research Institute (IPRI), ARC Centre of Excellence for Electromaterials Science (ACES), Australian Institute for Innovative Materials (AIIM), University of Wollongong, Innovation Campus, Wollongong, NSW 2522, Australia
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16
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Walker S, Dittfeld C, Jakob A, Schönfelder J, König U, Tugtekin SM. Sterilization and Cross-Linking Combined with Ultraviolet Irradiation and Low-Energy Electron Irradiation Procedure: New Perspectives for Bovine Pericardial Implants in Cardiac Surgery. Thorac Cardiovasc Surg 2020; 70:33-42. [PMID: 32114687 DOI: 10.1055/s-0040-1705100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Bovine pericardium is the major natural source of patches and aortic valve substitutes in cardiac repair procedures. However, long-term tissue durability and biocompatibility issues lead to degeneration (e.g., calcification) that requires reoperation. Tissue preparation strategies, including glutaraldehyde fixation, are reasons for the deterioration of pericardial tissues. We describe a pretreatment procedure involving sterilization and cross-linking combined with ultraviolet (UV) irradiation and low-energy electron irradiation (SULEEI). This innovative, glutaraldehyde-free protocol improves the mechanical aspects and biocompatibility of porcine pericardium patches. METHODS We adopted the SULEEI protocol, which combines decellularization, sterilization, and cross-linking, along with UV irradiation and low-energy electron irradiation, to pretreat bovine pericardium. Biomechanics, such as ultimate tensile strength and elasticity, were investigated by comparing SULEEI-treated tissue with glutaraldehyde-fixed analogues, clinical patch materials, and an aortic valve substitute. Histomorphological and cellular aspects were investigated by histology, DNA content analysis, and degradability. RESULTS Mechanical parameters, including ultimate tensile strength, elasticity (Young's modulus), and suture retention strength, were similar for SULEEI-treated and clinically applied bovine pericardium. The SULEEI-treated tissues showed well-preserved histoarchitecture that resembled all pericardial tissues investigated. Fiber density did not differ significantly. DNA content after the SULEEI procedure was reduced to less than 10% of the original tissue material, and more than 50% of the SULEEI-treated pericardium was digested by collagenase. CONCLUSION The SULEEI procedure represents a new treatment protocol for the preparation of patches and aortic valve prostheses from bovine pericardial tissue. The avoidance of glutaraldehyde fixation may lessen the tissue degeneration processes in cardiac repair patches and valve prostheses.
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Affiliation(s)
- Simona Walker
- Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
| | - Claudia Dittfeld
- Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Aline Jakob
- Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Jessy Schönfelder
- Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
| | - Ulla König
- Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
| | - Sems-Malte Tugtekin
- Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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17
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Wang D, Xiong Y, Zhang B, Zhang YF, Rosen D, Ge Q. Design framework for mechanically tunable soft biomaterial composites enhanced by modified horseshoe lattice structures. SOFT MATTER 2020; 16:1473-1484. [PMID: 31971207 DOI: 10.1039/c9sm02119a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Soft biomaterials have a wide range of applications in many areas. However, one material can only cover a specific range of mechanical performance such as the elastic modulus and stretchability. In order to improve the mechanical performance of soft biomaterials, lattice structures are embedded to reinforce the biomaterials. In this paper, rectangular and triangular lattice structures formed by modified horseshoe microstructures are used because their mechanical properties are tunable and can be tailored precisely to match the desired properties by adjusting four geometrical parameters, the length L, radius R, width w and arc angle θ0. A theoretical design framework for the modified horseshoe lattice structures is developed to predict the dependence of the mechanical behaviors on geometrical parameters. Both experiments and finite element simulations on lattice structures are conducted to validate the theoretical models. Results show that a wide range of design space for the elastic modulus (a few kPa to hundreds of MPa), stretchability (strain up to 180%) and Poisson ratio (ranging from -0.5 to 1.2) can be achieved. Experiments on lattice-hydrogel composites are also conducted to verify the reinforcement effect of lattice structures on the hydrogel. This work provides a theoretical method to predict the mechanical behaviors of the lattice structures and aid the rational design of reinforced biomaterials, which has applications in tissue engineering, drug delivery and intraocular lenses.
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Affiliation(s)
- Dong Wang
- Robotics Institute, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
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18
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Alhadrami HA, Syed RUR, Zahid AA, Ahmed R, Hasan S, Hasan A. Structure and Rheological Properties of Bovine Aortic Heart Valve and Pericardium Tissue: Implications in Bioprosthetic and Tissue-Engineered Heart Valves. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:3290370. [PMID: 31976052 PMCID: PMC6949733 DOI: 10.1155/2019/3290370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/09/2019] [Accepted: 11/29/2019] [Indexed: 11/18/2022]
Abstract
Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In many cases, impaired HV restoration is not always possible, and the replacement of valves becomes necessary. Bioprosthetic HVs have been used for the replacement of the diseased valves, which is obtained from the sources of bovine and porcine origin, while tissue-engineered heart valves (TEHV) have emerged as a promising future solution. The bioprosthetic valves are prone to become calcified, and thus they last for only ten to fifteen years. The adequate understanding of the correlations between the biomechanics and rheological properties of native HV tissues can enable us to improve the durability of the bioprosthetic HV as well as help in the development of tissue-engineered heart valves (TEHV). In this study, the structural and rheological properties of native bovine aortic HV and pericardium tissues were investigated. The microstructures of the tissues were investigated using scanning electron microscopy, while the rheological properties were studied using oscillatory shear measurement and creep test. The reported results provide significant insights into the correlations between the microstructure and viscoelastic properties of the bovine aortic HV and pericardium tissues.
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Affiliation(s)
- Hani A. Alhadrami
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, King Abdulaziz University, P.O. Box 80402, Jeddah 21589, Saudi Arabia
- King Fahd Medical Research Centre, King Abdulaziz University, P.O. Box 80402, Jeddah 21589, Saudi Arabia
| | - Raza ur Rehman Syed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | - Alap Ali Zahid
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | - Rashid Ahmed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | - Shajia Hasan
- College of Medicine, Qatar University, 2713 Doha, Qatar
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
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19
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Nguyen MTN, Doan VN, Tran HLB. In vitro study on chondrogenic differentiation of human adipose-derived stem cells on treated bovine pericardium. ACTA ACUST UNITED AC 2019; 43:360-370. [PMID: 31892811 PMCID: PMC6911261 DOI: 10.3906/biy-1908-10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Bovine pericardium has been proposed as an available material for tissue engineering and bioprosthetic reconstruction. In this study, bovine pericardium was fabricated into a scaffold for culturing and chondrogenic differentiation of human adipose-derived stem cells (hADSCs). Bovine pericardium was treated in 10 mM Tris-HCl and 0.15% SDS, followed by crosslinking in 0.1% glutaraldehyde. Treated bovine pericardium (tBP) was characterized as a slight yellowish thin membrane with enhanced tensile strength and strain property. The membrane maintained stability under enzymatic conditions for up to 16 days of incubation. The results confirmed tBP as a cell-friendly scaffold for hADSCs due to low cytotoxicity and its ability to support an appropriate attachment and proliferation of hADSCs. Moreover, there was an accumulation of the extracellular matrix proteoglycan in tBP seeded with hADSCs after 7 and 14 days of chondrogenic induction. COMP as a specific marker of chondrogenesis was detected after 7 days, whereas type X-a1 collagen (Col10a1) expression was stable up to day 14. However, minor expression of aggrecan was found. Taken together, these results indicate that tBP is a potential scaffold for hADSCs for cartilage tissue engineering.Key words: Bovine pericardium, scaffold, adipose-derived stem cells, chondrogenic differentiation, cartilage regeneration, augmentation rhinoplasty.
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Affiliation(s)
- My Thi Ngoc Nguyen
- Department of Physiology and Animal Biotechnology, Faculty of Biology and Biotechnology, University of Science, Vietnam National University, Ho Chi Minh City Vietnam.,Laboratory of Tissue Engineering and Biomedical Materials, University of Science, Vietnam National University, Ho Chi Minh City Vietnam
| | - Vu Nguyen Doan
- Department of Physiology and Animal Biotechnology, Faculty of Biology and Biotechnology, University of Science, Vietnam National University, Ho Chi Minh City Vietnam.,Laboratory of Tissue Engineering and Biomedical Materials, University of Science, Vietnam National University, Ho Chi Minh City Vietnam
| | - Ha Le Bao Tran
- Department of Physiology and Animal Biotechnology, Faculty of Biology and Biotechnology, University of Science, Vietnam National University, Ho Chi Minh City Vietnam.,Laboratory of Tissue Engineering and Biomedical Materials, University of Science, Vietnam National University, Ho Chi Minh City Vietnam
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20
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Polyisobutylene-Based Thermoplastic Elastomers for Manufacturing Polymeric Heart Valve Leaflets: In Vitro and In Vivo Results. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9224773] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Superior polymers represent a promising alternative to mechanical and biological materials commonly used for manufacturing artificial heart valves. The study is aimed at assessing poly(styrene-block-isobutylene-block-styrene) (SIBS) properties and comparing them with polytetrafluoroethylene (Gore-texTM, a reference sample). Surface topography of both materials was evaluated with scanning electron microscopy and atomic force microscopy. The mechanical properties were measured under uniaxial tension. The water contact angle was estimated to evaluate hydrophilicity/hydrophobicity of the study samples. Materials’ hemocompatibility was evaluated using cell lines (Ea.hy 926), donor blood, and in vivo. SIBS possess a regular surface relief. It is hydrophobic and has lower strength as compared to Gore-texTM (3.51 MPa vs. 13.2/23.8 MPa). SIBS and Gore-texTM have similar hemocompatibility (hemolysis, adhesion, and platelet aggregation). The subcutaneous rat implantation reports that SIBS has a lower tendency towards calcification (0.39 mg/g) compared with Gore-texTM (1.29 mg/g). SIBS is a highly hemocompatible material with a promising potential for manufacturing heart valve leaflets, but its mechanical properties require further improvements. The possible options include the reinforcement with nanofillers and introductions of new chains in its structure.
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21
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Fadeeva IS, Sorkomov MN, Zvyagina AI, Britikov DV, Sachkov AS, Evstratova YV, Fadeev RS, Muratov RM, Akatov VS. Study of Biointegration and Elastic-Strength Properties of a New Xenopericardium-Based Biomaterial for Reconstructive Cardiovascular Surgery. Bull Exp Biol Med 2019; 167:496-499. [PMID: 31494763 DOI: 10.1007/s10517-019-04558-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Indexed: 11/25/2022]
Abstract
We analyzed biocompatibility, elastic-strength properties, and biointegration potential of a new biomaterial made of xenopericardium for reconstructive cardiovascular surgery. The biomaterial manufactured by the proposed technology demonstrated high biocompatibility and biointegration potential and its elastic-strength properties 2-4-fold surpassed that of native pericardium. The obtained results attested to good prospects of using the proposed technology for preparing biomaterials for reconstructive cardiovascular surgery.
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Affiliation(s)
- I S Fadeeva
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region, Russia.
| | - M N Sorkomov
- A. N. Bakulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia
| | - A I Zvyagina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region, Russia
| | - D V Britikov
- A. N. Bakulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia
| | - A S Sachkov
- A. N. Bakulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia
| | - Ya V Evstratova
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region, Russia
| | - R S Fadeev
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region, Russia
| | - R M Muratov
- A. N. Bakulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia
| | - V S Akatov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region, Russia
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22
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Joyce K, Rochev Y, Rahmani S. Assessment of the uniaxial experimental parameters utilised for the mechanical testing of bovine pericardium. J Mech Behav Biomed Mater 2019; 96:27-37. [DOI: 10.1016/j.jmbbm.2019.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/09/2019] [Accepted: 04/13/2019] [Indexed: 11/26/2022]
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23
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Mao J, Rassoli A, Tong Y, Rouse EN, Le-Bel G, How D, Germain L, Fatouraee N, Zhang Z, Reed RR, Guidoin R. Donkey pericardium compares favorably with commercial xenopericardia used in the manufacture of transcatheter heart valves. Artif Organs 2019; 43:976-987. [PMID: 31140630 DOI: 10.1111/aor.13503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/18/2019] [Accepted: 05/21/2019] [Indexed: 12/16/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) has gained considerable acceptance in the past decade due to its lower risks than conventional open-heart surgery. However, the deformation and delamination of the leaflets during the crimping procedure have raised questions about the durability and long-term serviceability of the pericardium tissue from which the leaflets are made. The collagen architecture, wall thickness and mechanical properties of donkey pericardium were investigated to assess its suitability as an alternative material for the manufacture of heart valves. Coupons sampled from different locations of donkey pericardium were investigated. Bovine, equine, and porcine pericardium specimens served as controls. The donkey pericardium had a similar surface morphology to that of the control pericardia except for the wavy topology on both the fibrous and serous sides. The average thickness of donkey pericardium (ca. 120 µm) was significantly lower than that from bovine (375 µm) and equine (410 µm), but slightly higher than that from porcine (99 µm) specimens. The interlaced wavy collagen bundles in the pericardium were composed of collagen fibers about 100 nm in diameter. This unique structure ensures that the donkey pericardium has a comparable ultimate tensile strength (UTS) and a much higher failure strain than the commercial pericardia used for the manufacture of heart valves. The donkey pericardium has an organized wavy collagen bundle architecture similar to that of bovine pericardium and has a satisfactory UTS and high failure strain. The thin and strong donkey pericardium might be a good candidate valve leaflet material for TAVI.
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Affiliation(s)
- Jifu Mao
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
| | - Aisa Rassoli
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada.,Biological Fluid Mechanics Research Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Yiwei Tong
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
| | - Elizabeth Nicole Rouse
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, Knoxville, Tennessee
| | - Gaёtan Le-Bel
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
| | - Daniel How
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Lucie Germain
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
| | - Nasser Fatouraee
- Biological Fluid Mechanics Research Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Ze Zhang
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
| | - Robert R Reed
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, Knoxville, Tennessee
| | - Robert Guidoin
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC, Canada.,Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Québec, QC, Canada
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Marinho E, Carbonari RC, Malmonge SM, Leão CR. Mechanical behavior of bovine pericardium treated with hyaluronic acid derivative for bioprosthetic aortic valves. J Biomed Mater Res B Appl Biomater 2019; 107:2273-2280. [PMID: 30684295 DOI: 10.1002/jbm.b.34319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 12/04/2018] [Accepted: 12/19/2018] [Indexed: 11/07/2022]
Abstract
We studied the mechanical behavior of bovine pericardium (BP) after anticalcification treatment using hyaluronic acid (HA) derivative. To simulate the physiological environment and stimulate the calcification process, the BP samples were immersed into simulated body fluid solution. We conducted scanning electron microscopy with energy dispersive X-ray spectrometry, and uniaxial mechanical tests of HA-treated and non-treated samples. Although our microstructural analyses indicated that the HA treatment actually prevents the formation of calcium phosphate deposits, the mechanical tests show significant increase of stiffness of the HA-treated samples. Using data from our mechanical tests as input parameters, we performed finite element (FE) computer simulations to estimate how this increase in the BP stiffness affects the stress distribution in the bioprosthetic leaflet. Although the maximum stress observed during the closing phase of the membrane in vivo is below the experimental yield stress in all cases we analyzed, our FE results indicate that increase of BP stiffness due to HA anticalcification treatment results in higher risk of disruption and failure of the leaflets in bioprosthetic heart valves. Since our FE results indicate that the commissure and the fixed edge are the regions that withstand the highest mechanical stresses during the closing phase, new designs of the valve might be efficient to enhance the endurance of the prosthesis. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2273-2280, 2019.
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Affiliation(s)
- Enesio Marinho
- Centro de Engenharia, Modelagem e Ciências Sociais Aplicadas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo, 09210-580, Brazil
| | - Ronny Calixto Carbonari
- Centro de Engenharia, Modelagem e Ciências Sociais Aplicadas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo, 09210-580, Brazil
| | - Sonia M Malmonge
- Centro de Engenharia, Modelagem e Ciências Sociais Aplicadas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo, 09210-580, Brazil
| | - Cedric Rocha Leão
- Centro de Engenharia, Modelagem e Ciências Sociais Aplicadas, Universidade Federal do ABC, Avenida dos Estados, 5001, Santo André, São Paulo, 09210-580, Brazil
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25
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Meng S, Mao J, Rouse EN, Le-Bel G, Bourget JM, Reed RR, Philippe E, How D, Zhang Z, Germain L, Guidoin R. The Red Kangaroo pericardium as a material source for the manufacture of percutaneous heart valves. Morphologie 2019; 103:37-47. [PMID: 30638803 DOI: 10.1016/j.morpho.2018.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The kangaroo pericardium might be considered to be a good candidate material for use in the manufacture of the leaflets of percutaneous heart valves based upon the unique lifestyle. The diet consists of herbs, forbs and strubs. The kangaroo pericardium holds an undulated structure of collagen. MATERIAL AND METHOD A Red Kangaroo was obtained after a traffic fatality and the pericardium was dissected. Four compasses were cut from four different sites: auricular (AUR), atrial (ATR), sternoperitoneal (SPL) and phrenopericardial (PPL). They were investigated by means of scanning electron microscopy, light microscopy and transmission electron microscopy. RESULTS All the samples showed dense and wavy collagen bundles without vascularisation from both the epicardium and the parietal pericardium. The AUR and the ATR were 150±25μm thick whereas the SPL and the PPL were thinner at 120±20μm. The surface of the epicardium was smooth and glistening. The filaments of collagen were well individualized without any aggregation, but the banding was poorly defined and somewhat blurry. CONCLUSION This detailed morphological analysis of the kangaroo pericardium illustrated a surface resistant to thrombosis and physical characteristics resistant to fatigue. The morphological characteristics of the kangaroo pericardium indicate that it represents an outstanding alternative to the current sources e.g., bovine and porcine. However, procurement of tissues from the wild raises supply and sanitary issues. Health concerns based upon sanitary uncertainty and reliability of supply of wild animals remain real problems.
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Affiliation(s)
- S Meng
- Chongqing Key Lab of Catalysis and Functional Organic Molecules; College of Environment and Biotechnology, Chongqing Technology and Business University, Chongqing, PR China
| | - J Mao
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - E N Rouse
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - G Le-Bel
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - J M Bourget
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R R Reed
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - E Philippe
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - D How
- Peninsula College of Medicine and Dentistry (PCMD), Plymouth, Devon, UK
| | - Z Zhang
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - L Germain
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R Guidoin
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada.
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Hofferberth SC, Baird CW, Hoganson DM, Quiñonez LG, Emani SM, del Nido PJ, Hammer PE. Mechanical Properties of Autologous Pericardium Change With Fixation Time: Implications for Valve Reconstruction. Semin Thorac Cardiovasc Surg 2019; 31:852-854. [DOI: 10.1053/j.semtcvs.2019.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 03/01/2019] [Indexed: 11/11/2022]
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Grefen L, König F, Grab M, Hagl C, Thierfelder N. Pericardial tissue for cardiovascular application: an in-vitro evaluation of established and advanced production processes. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:172. [PMID: 30392024 DOI: 10.1007/s10856-018-6186-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/22/2018] [Indexed: 06/08/2023]
Abstract
Pericardial tissue is widely used as a biomaterial, especially for cardiovascular application. Tissue processing plays a key role in developing future scaffolds derived from biological material, yet standardized evaluation is still pending. This study presents a comprehensive assessment of different treatment protocols of bovine pericardium and compares those findings to commercially available decellularized bovine (CAB) and equine (CAE) pericardial patches. Native samples were fixed with glutaraldehyde (GA) or decellularized. These decellularized samples were subsequently either treated with GA (DEC-GA) or sterilized (DEC). Treatment effects were assessed by histological evaluation of structural and biomechanical properties. Furthermore, decellularization efficacy and accuracy of the applied sterilization protocol were evaluated. Cell seeding of processed pericardial samples with human endothelial cells constituted as biocompatibility test.GA-fixed tissue revealed structural deterioration, cytotoxicity and opposed to popular believe, GA-treatment did not lead to sterility of the samples. Biomechanical assessment revealed an increase in tensile strength of GA and a decrease of DEC and DEC-GA. DEC samples were successfully sterilized and showed good decellularization results, with a significant decrease in residual DNA. Comparative assessment revealed overall good results of CAE, yet results of CAB varied largely, e.g. decellularization efficacy or tissue thickness. Biocompatibility of DEC, CAB and CAE was confirmed by successful cell adhesion. Substantial differences of native tissue properties were observed, resulting in varying treatment efficacies. This study provides a first overview describing consequential variations among biomaterials and illustrates the necessity of multidimensional assessment and tissue quality management for biological scaffold development.
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Affiliation(s)
- L Grefen
- Department of Cardiac Surgery, Laboratory for Tissue Engineering, Grosshadern Medical Center, Ludwig Maximilian University of Munich, Munich, Germany.
| | - F König
- Department of Cardiac Surgery, Laboratory for Tissue Engineering, Grosshadern Medical Center, Ludwig Maximilian University of Munich, Munich, Germany
- Institute of Medical and Polymer Engineering, Technical University, Munich, Germany
| | - M Grab
- Department of Cardiac Surgery, Laboratory for Tissue Engineering, Grosshadern Medical Center, Ludwig Maximilian University of Munich, Munich, Germany
- Institute of Medical and Polymer Engineering, Technical University, Munich, Germany
| | - C Hagl
- Department of Cardiac Surgery, Laboratory for Tissue Engineering, Grosshadern Medical Center, Ludwig Maximilian University of Munich, Munich, Germany
| | - N Thierfelder
- Department of Cardiac Surgery, Laboratory for Tissue Engineering, Grosshadern Medical Center, Ludwig Maximilian University of Munich, Munich, Germany
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28
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Collagen fibre orientation and dispersion govern ultimate tensile strength, stiffness and the fatigue performance of bovine pericardium. J Mech Behav Biomed Mater 2018; 90:54-60. [PMID: 30343171 DOI: 10.1016/j.jmbbm.2018.09.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/29/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
The durability of bovine pericardium leaflets employed in bioprosthetic heart valves (BHVs) can significantly limit the longevity of heart valve prostheses. Collagen fibres are the dominant load bearing component of bovine pericardium, however fibre architecture within leaflet geometries is not explicitly controlled in the manufacture of commercial devices. Thus, the purpose of this study was to ascertain the influence of pre-determined collagen fibre orientation and dispersion on the mechanical performance of bovine pericardium. Three tissue groups were tested in uniaxial tension: cross-fibre tissue (XD); highly dispersed fibre-orientations (HD); or preferred-fibre tissue (PD). Both the XD and PD tissue were tested under cyclic loading at 1.5 Hz and a stress range of 2.7 MPa. The results of the static tensile experiments illustrated that collagen fibre orientation and degree of alignment significantly influenced the material's response, whereby, there was a statistically significant decrease in material properties between the XD groups and both the PD and HD groups for ultimate tensile strength and stiffness (p < 0.01). Furthermore, HD tissue had a stiffness of approximately 58% of the PD group, and XD tissue had a stiffness of approximately 18% of the PD group. The dynamic behaviour of the XD and PD groups was extremely distinct; for example a Weibull analysis indicated that the 50% probability of failure in specimens with fibres orientated perpendicular (XD) to the loading direction occurred at 375 cycles. Due to this failure, XD specimens survived on average less than 20% of the cycles completed by those in which fibres were aligned along the loading direction (PD). The results from this study indicate that fibre architecture is a significant factor in determining static strength and fatigue life in bovine pericardium, and thus must be incorporated in the design process to improve future device durability.
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29
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Sritharan D, Fathi P, Weaver JD, Retta SM, Wu C, Duraiswamy N. Impact of Clinically Relevant Elliptical Deformations on the Damage Patterns of Sagging and Stretched Leaflets in a Bioprosthetic Heart Valve. Cardiovasc Eng Technol 2018; 9:351-364. [PMID: 29948838 PMCID: PMC10451785 DOI: 10.1007/s13239-018-0366-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/21/2018] [Indexed: 01/31/2023]
Abstract
After implantation of a transcatheter bioprosthetic heart valve its original circular circumference may become distorted, which can lead to changes in leaflet coaptation and leaflets that are stretched or sagging. This may lead to early structural deterioration of the valve as seen in some explanted transcatheter heart valves. Our in vitro study evaluates the effect of leaflet deformations seen in elliptical configurations on the damage patterns of the leaflets, with circular valve deformation as the control. Bovine pericardial tissue heart valves were subjected to accelerated wear testing under both circular (N = 2) and elliptical (N = 4) configurations. The elliptical configurations were created by placing the valve inside custom-made elliptical holders, which caused the leaflets to sag or stretch. The hydrodynamic performance of the valves was monitored and high resolution images were acquired to evaluate leaflet damage patterns over time. In the elliptically deformed valves, sagging leaflets experienced more damage from wear compared to stretched leaflets; the undistorted leaflets of the circular valves experienced the least leaflet damage. Free-edge thinning and tearing were the primary modes of damage in the sagging leaflets. Belly region thinning was seen in the undistorted and stretched leaflets. Leaflet and fabric tears at the commissures were seen in all valve configurations. Free-edge tearing and commissure tears were the leading cause of valve hydrodynamic incompetence. Our study shows that mechanical wear affects heart valve pericardial leaflets differently based on whether they are undistorted, stretched, or sagging in a valve configuration. Sagging leaflets are more likely to be subjected to free-edge tear than stretched or undistorted leaflets. Reducing leaflet stress at the free edge of non-circular valve configurations should be an important factor to consider in the design and/or deployment of transcatheter bioprosthetic heart valves to improve their long-term performance.
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Affiliation(s)
- Deepa Sritharan
- Division of Applied Mechanics (DAM), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, WO62, #2206, Silver Spring, MD, 20993, USA
| | - Parinaz Fathi
- Division of Applied Mechanics (DAM), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, WO62, #2206, Silver Spring, MD, 20993, USA
| | - Jason D Weaver
- Division of Applied Mechanics (DAM), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, WO62, #2206, Silver Spring, MD, 20993, USA
| | - Stephen M Retta
- Division of Applied Mechanics (DAM), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, WO62, #2206, Silver Spring, MD, 20993, USA
| | - Changfu Wu
- Division of Cardiovascular Devices (DCD), Office of Device Evaluation (ODE), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Nandini Duraiswamy
- Division of Applied Mechanics (DAM), Office of Science and Engineering Laboratories (OSEL), Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, WO62, #2206, Silver Spring, MD, 20993, USA.
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Label-Free Assessment of Collagenase Digestion on Bovine Pericardium Properties by Fluorescence Lifetime Imaging. Ann Biomed Eng 2018; 46:1870-1881. [PMID: 30003502 DOI: 10.1007/s10439-018-2087-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/27/2018] [Indexed: 01/01/2023]
Abstract
The extracellular matrix architecture of bovine pericardium (BP) has distinct biochemical and biomechanical properties that make it a useful biomaterial in the field of regenerative medicine. Collagen represents the dominant structural protein of BP and is therefore intimately associated with the properties of this biomaterial. Enzymatic degradation of collagen molecules is critical for extracellular matrix turnover, remodeling and ultimately tissue regeneration. We present a quantitative, label-free and non-destructive method for monitoring changes in biochemical and biomechanical properties of BP during tissue degradation, based on multi-spectral fluorescence lifetime imaging (ms-FLIm). Strong correlations of fluorescence intensity ratio and average fluorescence lifetime were identified with collagen content, Young's Modulus and Ultimate tensile strength during collagenase degradation, indicating the potential of optically monitoring collagen degradation using ms-FLIm. The obtained results demonstrate the value of ms-FLIm to assess the quality of biomaterials in situ for applications in regenerative medicine.
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31
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Barone A, Benktander J, Whiddon C, Jin C, Galli C, Teneberg S, Breimer ME. Glycosphingolipids of porcine, bovine, and equine pericardia as potential immune targets in bioprosthetic heart valve grafts. Xenotransplantation 2018; 25:e12406. [PMID: 29932253 DOI: 10.1111/xen.12406] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/28/2018] [Accepted: 04/13/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pericardial tissue from various animal species is utilized for the production of the bioprosthetic heart valves (BHV) used clinically. Experimental data show that the eventual breakdown of BHV is partly due to immunological interactions with carbohydrate tissue antigens. To understand these processes, we have examined the glycolipid-based carbohydrate antigens in naïve porcine, bovine, and equine pericardia. EXPERIMENTAL Total non-acid and acid glycosphingolipid fractions were isolated from porcine, bovine, and equine pericardia, and individual glycolipid compounds were characterized by thin-layer chromatography, mass spectrometry, and binding of monoclonal antibodies, lectins and bacteria in chromatogram binding assays. RESULTS The non-acid glycolipid fractions from all species contained glycosphingolipids based on the globo- and neolacto-series, including pentaglycosylceramides with terminal Galα3 determinants. Terminal blood group A and H (O) structures based on type 2 core chains were present in porcine pericardium, while the Forssman pentaosylceramide was found in equine pericardium. All acid glycolipid fractions contained sulfatide and several gangliosides with both N-acetyl- and N-glycolyl-neuraminic acid as terminal saccharide chain determinants. CONCLUSION Several carbohydrate antigens which are potential targets for the human immune system have been identified in the animal pericardial tissues used for the production of BHV. Which of these antigens are left in the tissues after industrial BHV production processes, as well as their potential role in eventual BHV degradation, remains to be elucidated.
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Affiliation(s)
- Angela Barone
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - John Benktander
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christy Whiddon
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Chunsheng Jin
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cesare Galli
- Avantea Laboratory of Reproductive Technologies, Cremona, Italy
| | - Susann Teneberg
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Michael E Breimer
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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A sterilization method for decellularized xenogeneic cardiovascular scaffolds. Acta Biomater 2018; 67:282-294. [PMID: 29183849 DOI: 10.1016/j.actbio.2017.11.035] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 11/09/2017] [Accepted: 11/21/2017] [Indexed: 01/09/2023]
Abstract
Decellularized xenogeneic scaffolds have shown promise to be employed as compatible and functional cardiovascular biomaterials. However, one of the main barriers to their clinical exploitation is the lack of appropriate sterilization procedures. This study investigated the efficiency of a two-step sterilization method, antibiotics/antimycotic (AA) cocktail and peracetic acid (PAA), on porcine and bovine decellularized pericardium. In order to assess the efficiency of the method, a sterilization assessment protocol was specifically designed, comprising: i) controlled contamination with a known amount of bacteria; ii) sterility test; iii) identification of contaminants through MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight) mass spectrometry and iv) quantification by the Most Probable Number (MPN) method. This sterilization assessment protocol proved to be a successful tool to monitor and optimize the proposed sterilization method. The treatment with AA + PAA method provided sterile scaffolds while preserving the structural integrity and biocompatibility of the decellularized porcine and bovine tissues. However, surface properties and cellular adhesion resulted slightly impaired on porcine pericardium. This work developed a sterilization method suitable for decellularized pericardial scaffolds that could be adopted for in vivo tissue engineering. Together with the proposed sterilization assessment protocol, this decontamination method will foster the clinical translation of decellularized xenogeneic substitutes. STATEMENT OF SIGNIFICANCE Clinical application of functional and compatible xenogeneic decellularized scaffolds has been delayed due to the lack of appropriate sterilization methodologies. In this study, it was investigated an effective sterilization method optimized for porcine and bovine decellularized pericardia, based on the use of antibiotics/antimycotics followed by peracetic acid treatment. This treatment effectively sterilizes both species scaffolds, proves to maintain tissue overall structure and components, preserves biocompatibility and biomechanical properties. Furthermore, it was also developed a sterilization assessment protocol used to monitor and validate the previous method, consisting in three main parts: i) controlled contamination; ii) sterility test, and iii) identification and quantification of contaminants. Both methodologies were optimized for the tissues in study but can be applied to other scaffolds and accelerate their clinical translation.
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Straka F, Schornik D, Masin J, Filova E, Mirejovsky T, Burdikova Z, Svindrych Z, Chlup H, Horny L, Daniel M, Machac J, Skibová J, Pirk J, Bacakova L. A human pericardium biopolymeric scaffold for autologous heart valve tissue engineering: cellular and extracellular matrix structure and biomechanical properties in comparison with a normal aortic heart valve. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:599-634. [PMID: 29338582 DOI: 10.1080/09205063.2018.1429732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of our study was to compare the cellular and extracellular matrix (ECM) structure and the biomechanical properties of human pericardium (HP) with the normal human aortic heart valve (NAV). HP tissues (from 12 patients) and NAV samples (from 5 patients) were harvested during heart surgery. The main cells in HP were pericardial interstitial cells, which are fibroblast-like cells of mesenchymal origin similar to the valvular interstitial cells in NAV tissue. The ECM of HP had a statistically significantly (p < 0.001) higher collagen I content, a lower collagen III and elastin content, and a similar glycosaminoglycans (GAGs) content, in comparison with the NAV, as measured by ECM integrated density. However, the relative thickness of the main load-bearing structures of the two tissues, the dense part of fibrous HP (49 ± 2%) and the lamina fibrosa of NAV (47 ± 4%), was similar. In both tissues, the secant elastic modulus (Es) was significantly lower in the transversal direction (p < 0.05) than in the longitudinal direction. This proved that both tissues were anisotropic. No statistically significant differences in UTS (ultimate tensile strength) values and in calculated bending stiffness values in the longitudinal or transversal direction were found between HP and NAV. Our study confirms that HP has an advantageous ECM biopolymeric structure and has the biomechanical properties required for a tissue from which an autologous heart valve replacement may be constructed.
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Affiliation(s)
- Frantisek Straka
- a Cardiology Centre and Cardiovascular Surgery Department , Institute for Clinical and Experimental Medicine , Prague , Czech Republic.,b Department of Biomaterials and Tissue Engineering , Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic
| | - David Schornik
- b Department of Biomaterials and Tissue Engineering , Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic
| | - Jaroslav Masin
- a Cardiology Centre and Cardiovascular Surgery Department , Institute for Clinical and Experimental Medicine , Prague , Czech Republic
| | - Elena Filova
- b Department of Biomaterials and Tissue Engineering , Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic
| | - Tomas Mirejovsky
- c Clinical and Transplant Pathology Department, Institute for Clinical and Experimental Medicine , Prague , Czech Republic
| | - Zuzana Burdikova
- d Department of Cell Biology, School of Medicine , University of Virginia , Charlottesville , VA , USA
| | - Zdenek Svindrych
- e Department of Biology, W. M, Keck Center for Cellular Imaging , University of Virginia , Charlottesville , VA , USA
| | - Hynek Chlup
- f Faculty of Mechanical Engineering, Department of Mechanics, Biomechanics and Mechatronics , Czech Technical University in Prague , Prague , Czech Republic
| | - Lukas Horny
- f Faculty of Mechanical Engineering, Department of Mechanics, Biomechanics and Mechatronics , Czech Technical University in Prague , Prague , Czech Republic
| | - Matej Daniel
- f Faculty of Mechanical Engineering, Department of Mechanics, Biomechanics and Mechatronics , Czech Technical University in Prague , Prague , Czech Republic
| | - Jiri Machac
- g Institute of Botany CAS, Academy of Sciences of the Czech Republic , Pruhonice , Czech Republic
| | - Jelena Skibová
- h Department of Medical Statistics , Institute for Clinical and Experimental Medicine , Prague , Czech Republic
| | - Jan Pirk
- a Cardiology Centre and Cardiovascular Surgery Department , Institute for Clinical and Experimental Medicine , Prague , Czech Republic
| | - Lucie Bacakova
- b Department of Biomaterials and Tissue Engineering , Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic
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Bagno A, Aguiari P, Fiorese M, Iop L, Spina M, Gerosa G. Native Bovine and Porcine Pericardia Respond to Load With Additive Recruitment of Collagen Fibers. Artif Organs 2017; 42:540-548. [PMID: 29280157 DOI: 10.1111/aor.13065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/29/2017] [Accepted: 09/08/2017] [Indexed: 12/20/2022]
Abstract
Bovine and porcine pericardia are currently used for manufacturing prosthetic heart valves: their design has become an increasingly important area of investigation in parallel with progressively expanding indications for the transcutaneous approach to heart valves replacement. Before being cut and shaped, pericardial tissues are expected to be properly characterized. Actually, the mechanical assessment of these biomaterials lacks standardized protocols. In particular, the role of preconditioning for achieving a constant mechanical response of tissue samples is still controversial. In the present work, the mechanical response to uniaxial load of native bovine and porcine pericardia, with and without preconditioning was assessed; moreover, the mechanical behavior of pericardia was investigated and explained. It was demonstrated that: (i) pericardial tissue samples hold memory of the loading history but just within the extent of the deformation applied; (ii) the behavior of native bovine and porcine pericardia in response to load is explained by a mechanism based on the additive recruitment of collagen fibers; (iii) the current concept that plasticity is absent in pericardium has to be at least in part reconsidered.
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Affiliation(s)
- Andrea Bagno
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Paola Aguiari
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Michele Fiorese
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Laura Iop
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Michele Spina
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Park D, Yong IS, Cho KJ, Cheng J, Jung Y, Kim SH, Lee SH. Thae use of microfluic spinning fiber as an ophthalmology suture showing the good anastomotic strength control. Sci Rep 2017; 7:16264. [PMID: 29176617 PMCID: PMC5701120 DOI: 10.1038/s41598-017-16462-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/13/2017] [Indexed: 11/09/2022] Open
Abstract
Adjusting the mechanical strength of a biomaterial to suit its intended application is very important for realizing beneficial outcomes. Microfluidic spinning fiber have been attracting attention recently due to their various advantages, but their mechanical strength has unfortunately not been a subject of concentrated research, and this lack of research has severely limited their applications. In the current work, we showed the mechanical properties of microfibers can be tuned easily and provided a mathematical explanation for how the microfluidic spinning method intrinsically controls the mechanical properties of a microfluidic spinning fiber. But we were also able to adjust the mechanical properties of such fibers in various other ways, including by using biomolecules to coat the fiber or mixing the biomolecules with the primary component of the fiber and by using a customized twisting machine to change the number of single microfiber strands forming the fiber. We used the bundle fiber as an ophthalmology suture that resulted in a porcine eye with a smoother post-operative surface than did a nylon suture. The results showed the possibility that the proposed method can solve current problems of the microfibers in practical applications, and can thus extend the range of applications of these microfibers.
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Affiliation(s)
- DoYeun Park
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - In Sung Yong
- Department of Bio and Brain Engineering, KAIST, Daejeon, 34141, Republic of Korea
| | - Kyong Jin Cho
- Department of Ophthalmology, College of Medicine, Dankook University, 119 Danaeo-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31116, Republic of Korea
| | - Jie Cheng
- MOE Key Laboratory of Spectrochemical Analysis & Instrumentation, Collaborative Innovation Center of Chemistry for Energy Materials, Key Laboratory for Chemical Biology of Fujian Province, State Key Laboratory of Physical Chemistry of Solid Surfaces, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, 361005, China
| | - Youngmee Jung
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Soo Hyun Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea.
| | - Sang-Hoon Lee
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- School of Biomedical Engineering, College of Health Science, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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Caballero A, Sulejmani F, Martin C, Pham T, Sun W. Evaluation of transcatheter heart valve biomaterials: Biomechanical characterization of bovine and porcine pericardium. J Mech Behav Biomed Mater 2017; 75:486-494. [PMID: 28826102 PMCID: PMC5614867 DOI: 10.1016/j.jmbbm.2017.08.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Bovine pericardium (BP) has been identified as a choice biomaterial for the development of surgical bioprosthetic heart valves (BHV) and transcatheter aortic valves (TAV). Porcine pericardium (PP) and younger BP have been suggested as candidates TAV leaflet biomaterials for smaller-profile devices due to their reduced thickness; however, their mechanical and structural properties remain to be fully characterized. This study characterized the material properties of chemically treated thick (PPK) and thin (PPN) PP, as well as fetal (FBP), calf (CBP) and adult (ABP) BP tissues in order to better understand their mechanical behavior. METHODS Planar biaxial testing and uniaxial failure testing methods were employed to quantify tissue mechanical responses and failure properties. Fiber characteristics were examined using histological analysis. RESULTS ABP and CBP tissues were significantly stiffer and stronger than the younger FBP tissues. Histological analysis revealed a significantly larger concentration of thin immature collagen fibers in the FBP tissues than in the ABP and CBP tissues. While PP tissues were thinnest, they were stiffer and less extensible than the BP tissues. CONCLUSIONS Due to comparable mechanical properties but significantly reduced thickness, CBP tissue may be a more suitable material for TAV manufacturing than ABP tissue. FBP tissue, despite its reduced thickness and higher flexibility, was weaker and should be studied in more detail. Although PP tissues are the thinnest, they were least extensible and failed at earlier strain than BP tissues. The differences between PP and BP tissues should be further investigated and suggest that they should not be used interchangeably in the manufacturing of TAV.
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Affiliation(s)
- Andrés Caballero
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Fatiesa Sulejmani
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Caitlin Martin
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Thuy Pham
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Wei Sun
- Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States.
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Murdock K, Martin C, Sun W. Characterization of mechanical properties of pericardium tissue using planar biaxial tension and flexural deformation. J Mech Behav Biomed Mater 2017; 77:148-156. [PMID: 28915471 DOI: 10.1016/j.jmbbm.2017.08.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/21/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022]
Abstract
Flexure is an important mode of deformation for native and bioprosthetic heart valves. However, mechanical characterization of bioprosthetic leaflet materials has been done primarily through planar tensile testing. In this study, an integrated experimental and computational cantilever beam bending test was performed to characterize the flexural properties of glutaraldehyde-treated bovine and porcine pericardium of different thicknesses. A strain-invariant based structural constitutive model was used to model the pericardial mechanical behavior quantified through the bending tests of this study and the planar biaxial tests previously performed. The model parameters were optimized through an inverse finite element (FE) procedure in order to describe both sets of experimental data. The optimized material properties were implemented in FE simulations of transcatheter aortic valve (TAV) deformation. It was observed that porcine pericardium TAV leaflets experienced significantly more flexure than bovine when subjected to opening pressurization, and that the flexure may be overestimated using a constitutive model derived from purely planar tensile experimental data. Thus, modeling of a combination of flexural and biaxial tensile testing data may be necessary to more accurately describe the mechanical properties of pericardium, and to computationally investigate bioprosthetic leaflet function and design.
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Affiliation(s)
- Kyle Murdock
- Tissue Mechanics Laboratory, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Caitlin Martin
- Tissue Mechanics Laboratory, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Wei Sun
- Tissue Mechanics Laboratory, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States.
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Bozkurt S, Preston-Maher GL, Torii R, Burriesci G. Design, Analysis and Testing of a Novel Mitral Valve for Transcatheter Implantation. Ann Biomed Eng 2017; 45:1852-1864. [PMID: 28374279 PMCID: PMC5527080 DOI: 10.1007/s10439-017-1828-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 03/25/2017] [Indexed: 12/31/2022]
Abstract
Mitral regurgitation is a common mitral valve dysfunction which may lead to heart failure. Because of the rapid aging of the population, conventional surgical repair and replacement of the pathological valve are often unsuitable for about half of symptomatic patients, who are judged high-risk. Transcatheter valve implantation could represent an effective solution. However, currently available aortic valve devices are inapt for the mitral position. This paper presents the design, development and hydrodynamic assessment of a novel bi-leaflet mitral valve suitable for transcatheter implantation. The device consists of two leaflets and a sealing component made from bovine pericardium, supported by a self-expanding wireframe made from superelastic NiTi alloy. A parametric design procedure based on numerical simulations was implemented to identify design parameters providing acceptable stress levels and maximum coaptation area for the leaflets. The wireframe was designed to host the leaflets and was optimised numerically to minimise the stresses for crimping in an 8 mm sheath for percutaneous delivery. Prototypes were built and their hydrodynamic performances were tested on a cardiac pulse duplicator, in compliance with the ISO5840-3:2013 standard. The numerical results and hydrodynamic tests show the feasibility of the device to be adopted as a transcatheter valve implant for treating mitral regurgitation.
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Affiliation(s)
- Selim Bozkurt
- UCL Mechanical Engineering, Cardiovascular Engineering Laboratory, University College London, London, WC1E 7JE, UK
| | - Georgia L Preston-Maher
- UCL Mechanical Engineering, Cardiovascular Engineering Laboratory, University College London, London, WC1E 7JE, UK
| | - Ryo Torii
- UCL Mechanical Engineering, Cardiovascular Engineering Laboratory, University College London, London, WC1E 7JE, UK
| | - Gaetano Burriesci
- UCL Mechanical Engineering, Cardiovascular Engineering Laboratory, University College London, London, WC1E 7JE, UK. .,Ri.MED Foundation, Bioengineering Group, Palermo, Italy.
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Chen H, Zhao X, Berwick ZC, Krieger JF, Chambers S, Kassab GS. Microstructure and Mechanical Property of Glutaraldehyde-Treated Porcine Pulmonary Ligament. J Biomech Eng 2016; 138:061003. [PMID: 27040732 DOI: 10.1115/1.4033300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Indexed: 01/15/2023]
Abstract
There is a significant need for fixed biological tissues with desired structural and material constituents for tissue engineering applications. Here, we introduce the lung ligament as a fixed biological material that may have clinical utility for tissue engineering. To characterize the lung tissue for potential clinical applications, we studied glutaraldehyde-treated porcine pulmonary ligament (n = 11) with multiphoton microscopy (MPM) and conducted biaxial planar experiments to characterize the mechanical property of the tissue. The MPM imaging revealed that there are generally two families of collagen fibers distributed in two distinct layers: The first family largely aligns along the longitudinal direction with a mean angle of θ = 10.7 ± 9.3 deg, while the second one exhibits a random distribution with a mean θ = 36.6 ± 27.4. Elastin fibers appear in some intermediate sublayers with a random orientation distribution with a mean θ = 39.6 ± 23 deg. Based on the microstructural observation, a microstructure-based constitutive law was proposed to model the elastic property of the tissue. The material parameters were identified by fitting the model to the biaxial stress-strain data of specimens, and good fitting quality was achieved. The parameter e0 (which denotes the strain beyond which the collagen can withstand tension) of glutaraldehyde-treated tissues demonstrated low variability implying a relatively consistent collagen undulation in different samples, while the stiffness parameters for elastin and collagen fibers showed relatively greater variability. The fixed tissues presented a smaller e0 than that of fresh specimen, confirming that glutaraldehyde crosslinking increases the mechanical strength of collagen-based biomaterials. The present study sheds light on the biomechanics of glutaraldehyde-treated porcine pulmonary ligament that may be a candidate for tissue engineering.
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