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Zhou H, Wu Q, Wu L, Zhao Y. Mechanical behaviors of high-strength fabric composite membrane designed for cardiac valve prosthesis replacement. J Mech Behav Biomed Mater 2023; 142:105863. [PMID: 37116312 DOI: 10.1016/j.jmbbm.2023.105863] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023]
Abstract
Bovine pericardium has been commonly used as leaflets in cardiac valve prosthesis replacement for decades because of its good short-term hemocompatibility and hemodynamic performance. However, fatigue, abrasion, permanent deformation, calcification, and many other failure modes have been reported as well. The degradation of the performance will have a serious impact on the function of valve prostheses, posing a risk to the patient's health. This study aimed to introduce a flexible fabric composite with better mechanical performance such that it can be employed as a substitute material for bioprosthetic valve leaflets. This composite has a multilayered thin film structure made of ultrahigh molecular weight polyethylene (UHMWPE) fabric and thermoplastic polyurethane (TPU) membranes. The mechanical properties of three specifications with different design parameters were tested. The tensile strength, shear behavior, tear resistance, and bending stiffness of the composites were characterized and compared to those of bovine pericardium. A constitutive model was also established to describe the composites' mechanical behaviors and predict their strength. According to the results of the tests, the composite could maintain a flexible bending stiffness with high in-plane tensile strength and tear strength. Therefore, bioprosthetic valve made of this substitute material can withstand harsher loads in the blood flow environment than those made of bovine pericardium. Moreover, all these test results and constitutive models can be used in future research to evaluate hemodynamic performance and clinical applications of fabric composite valve prostheses.
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Affiliation(s)
- Han Zhou
- Center for Composite Materials, Harbin Institute of Technology, Harbin, 150001, China; National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin, 150001, China
| | - Qianqian Wu
- Center for Composite Materials, Harbin Institute of Technology, Harbin, 150001, China; National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin, 150001, China.
| | - Linzhi Wu
- Center for Composite Materials, Harbin Institute of Technology, Harbin, 150001, China; National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin, 150001, China; Key Laboratory of Advanced Ship Materials and Mechanics, Harbin Engineering University, Harbin, 150001, China
| | - Yang Zhao
- Center for Composite Materials, Harbin Institute of Technology, Harbin, 150001, China; National Key Laboratory of Science and Technology on Advanced Composites in Special Environments, Harbin Institute of Technology, Harbin, 150001, China
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Tseng YT, Grace NF, Aguib H, Sarathchandra P, McCormack A, Ebeid A, Shehata N, Nagy M, El-Nashar H, Yacoub MH, Chester A, Latif N. Biocompatibility and Application of Carbon Fibers in Heart Valve Tissue Engineering. Front Cardiovasc Med 2022; 8:793898. [PMID: 35004904 PMCID: PMC8739227 DOI: 10.3389/fcvm.2021.793898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/29/2021] [Indexed: 12/03/2022] Open
Abstract
The success of tissue-engineered heart valves rely on a balance between polymer degradation, appropriate cell repopulation, and extracellular matrix (ECM) deposition, in order for the valves to continue their vital function. However, the process of remodeling is highly dynamic and species dependent. The carbon fibers have been well used in the construction industry for their high tensile strength and flexibility and, therefore, might be relevant to support tissue-engineered hearts valve during this transition in the mechanically demanding environment of the circulation. The aim of this study was to assess the suitability of the carbon fibers to be incorporated into tissue-engineered heart valves, with respect to optimizing their cellular interaction and mechanical flexibility during valve opening and closure. The morphology and surface oxidation of the carbon fibers were characterized by scanning electron microscopy (SEM). Their ability to interact with human adipose-derived stem cells (hADSCs) was assessed with respect to cell attachment and phenotypic changes. hADSCs attached and maintained their expression of stem cell markers with negligible differentiation to other lineages. Incorporation of the carbon fibers into a stand-alone tissue-engineered aortic root, comprised of jet-sprayed polycaprolactone aligned carbon fibers, had no negative effects on the opening and closure characteristics of the valve when simulated in a pulsatile bioreactor. In conclusion, the carbon fibers were found to be conducive to hADSC attachment and maintaining their phenotype. The carbon fibers were sufficiently flexible for full motion of valvular opening and closure. This study provides a proof-of-concept for the incorporation of the carbon fibers into tissue-engineered heart valves to continue their vital function during scaffold degradation.
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Affiliation(s)
- Yuan-Tsan Tseng
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom
| | - Nabil F Grace
- Centre for Innovative Materials Research, Lawrence Technological University, Southfield, MI, United States
| | - Heba Aguib
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom.,Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | | | - Ann McCormack
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom
| | - Ahmed Ebeid
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Nairouz Shehata
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Mohamed Nagy
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Hussam El-Nashar
- Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Magdi H Yacoub
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom.,Biomedical Engineering and Innovation Laboratory, Aswan Heart Centre, Aswan, Egypt
| | - Adrian Chester
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom
| | - Najma Latif
- Heart Science Centre, Magdi Yacoub Institute, Harefield, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom
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Gavardinas ID, Spyrou LA, Zervaki A, Spanos K, Giannoukas AD, Giannakopoulos AE. Fatigue of textiles used in vascular surgery: Application to carotid endarterectomy. J Mech Behav Biomed Mater 2020; 113:104121. [PMID: 33186812 DOI: 10.1016/j.jmbbm.2020.104121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/05/2020] [Accepted: 09/28/2020] [Indexed: 11/24/2022]
Abstract
Fatigue is a material-based phenomenon playing a significant role in the mechanical behavior of components and structures. Although fatigue has been well studied for traditional materials, such as metals, its underlying mechanisms are not thoroughly understood in novel applications such as the case of textiles used as patches to close the arteriotomy in carotid endarterectomy. The latter is a type of vascular surgery for the treatment of carotid artery disease in which after an arteriotomy and removal of atherosclerotic plaque closure is made with a patch sutured on the artery. Completion of the operation signals the initiation of complex mechanical and hemodynamic phenomena. Fatigue performance of the patch eventually determines the successful outcome of carotid endarterectomy. In this study, we evaluate with a two-fold approach the mechanics of patch angioplasty in carotid endarterectomy. First, an analytical model for the fatigue behavior of textiles is developed, considering the microstructure and geometry of the fabric. Then, the surgical procedure is simulated and a finite element analysis of the endarterectomized and patched carotid artery is employed. Stress fields are calculated, while deformation at the site of patch angioplasty indicates a potential cause for the formation of aneurismal degeneration after the surgery. Such analysis can provide a better understanding in the establishment of follow-up protocols.
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Affiliation(s)
- I D Gavardinas
- Laboratory for Strength of Materials and Micromechanics, Department of Civil Engineering, University of Thessaly, Volos, Greece.
| | - L A Spyrou
- Biomechanics Group, Institute for Bio-Economy and Agri-Technology, Centre for Research & Technology Hellas (CERTH), Volos, Greece.
| | - A Zervaki
- Laboratory of Materials, Department of Mechanical Engineering, University of Thessaly, Volos, Greece.
| | - K Spanos
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
| | - A D Giannoukas
- Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
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