Bioinspired polymeric heart valves: A combined in vitro and in silico approachCentral MessagePerspective
Aeryne Lee, PhD,
Xinying Liu, PhD,
Jacopo Emilio Giaretta, PhD,
Thanh Phuong Hoang,
Matthew Crago, BE,
Syamak Farajikhah, PhD,
Luke Mosse, PhD,
David Frederick Fletcher, PhD,
Fariba Dehghani, PhD,
David Scott Winlaw, MD,
Sina Naficy, PhD
Affiliations
Aeryne Lee, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia; School of Medicine, The University of Sydney, Camperdown, Australia
Xinying Liu, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia
Jacopo Emilio Giaretta, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia
Thanh Phuong Hoang
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia
Matthew Crago, BE
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia
Syamak Farajikhah, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia; Sydney Nano Institute, The University of Sydney, Camperdown, Australia
Luke Mosse, PhD
Leap Australia, Clayton North, Australia
David Frederick Fletcher, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia
Fariba Dehghani, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia; Sydney Nano Institute, The University of Sydney, Camperdown, Australia
David Scott Winlaw, MD
School of Medicine, The University of Sydney, Camperdown, Australia; Department of Cardiothoracic Surgery, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio
Sina Naficy, PhD
School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, Australia; School of Medicine, The University of Sydney, Camperdown, Australia; Sydney Nano Institute, The University of Sydney, Camperdown, Australia; Address for reprints: Sina Naficy, PhD, School of Chemical and Biomolecular Engineering J01, The University of Sydney, Cnr Shepherd & Lander Street, Darlington, NSW 2008, Australia.
Background: Polymeric heart valves (PHVs) may address the limitations of mechanical and tissue valves in the treatment of valvular heart disease. In this study, a bioinspired valve was designed, assessed in silico, and validated by an in vitro model to develop a valve with optimum function for pediatric applications. Methods: A bioinspired heart valve was created computationally with leaflet curvature derived from native valve anatomies. A valve diameter of 18 mm was chosen to approach sizes suitable for younger patients. Valves of different thicknesses were fabricated via dip-coating with siloxane-based polyurethane and tested in a pulse duplicator for their hydrodynamic function. The same valves were tested computationally using an arbitrary Lagrangian–Eulerian plus immersed solid approach, in which the fluid–structure interaction between the valves and fluid passing through them was studied and compared with experimental data. Results: Computational analysis showed that valves of 110 to 200 μm thickness had effective orifice areas (EOAs) of 1.20 to 1.30 cm2, with thinner valves exhibiting larger openings. In vitro tests demonstrated that PHVs of similar thickness had EOAs of 1.05 to 1.35 cm2 and regurgitant fractions (RFs) <7%. Valves with thinner leaflets exhibited optimal systolic performance, whereas thicker valves had lower RFs. Conclusions: Bioinspired PHVs demonstrated good hydrodynamic performance that exceeded ISO 5840-2 standards. Both methods of analysis showed similar correlations between leaflet thickness and valve systolic function. Further development of this PHV may lead to enhanced durability and thus a more reliable heart valve replacement than contemporary options.
