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POTENTIAL BENEFITS FOR USING ePTFE AS A MATERIAL FOR PROSTHETIC HEART VALVES

https://doi.org/10.17802/2306-1278-2018-7-2-79-88

Abstract

Background The current study highlights potential benefits of using ePTFE, a polymeric material, as the main component suitable for fabrication of prosthetic heart valves. Novel polymeric materials seem to be promising for replacing biological elements commonly used in medical products for cardiovascular surgery. High biocompatibility and mechanical properties prolong their lifespan during direct blood contact. Nevertheless, it is necessary to conduct a series of specific tests to determine their properties and benefits of their application. Despite well-known biological properties of ePTFE, there are few studies assessing it as a material for heart valve leaflets. Aim To evaluate the mechanical properties of the commercially available sample of ePTFE and to conduct a numerical experiment assessing its potential for the application. Methods The polymer properties (Gore & Associates Inc., USA) were evaluated under uniaxial tension in two mutually perpendicular directions to determine the degree of anisotropy of the material. A xenopericardial patch (ZAO “NeoCor”, Russia), routinely used for the fabrication of bioprosthetic leaflets, was taken as the control sample. The spatial model of the investigated material was carried out in CAD SolidWorks 2016 (Dassault Systemes, USA). Numerical modeling of the samples was performed with the finite element method using the orthotropic material model in the Abaqus/CAE (Dassault Systemes, USA). Results There are significant difference found in the mechanical properties of the studied materials: the tension at stretching of ePTFE in the longitudinal and transverse directions differed from xenopericardium by 1.9 and 7.5 times, respectively (p<0.05). The elongation before rupture of ePTFE in direction I and direction II was greater than that of xenopericardium (2.39 vs. 1.9 times, respectively). Numerical modeling demonstrated insignificant qualitative differences in the valve opening while applying pressure equal to normal physiological pressure>< 0.05). The elongation before rupture of ePTFE in direction I and direction II was greater than that of xenopericardium (2.39 vs. 1.9 times, respectively). Numerical modeling demonstrated insignificant qualitative differences in the valve opening while applying pressure equal to normal physiological pressure and low pressure. In addition, the zones of high stress in commissural racks, which are critical zones for fatigue resistance, have been identified, albeit require additional in vitro research. Conclusion Mechanical properties of ePTFE suggests it to be a promising polymeric material suitable for fabrication of flexible leaflets of the heart valve prosthesis. It has similar leaflet functioning, compared with the xenopericardium sample, routinely used in manufacturing. ePTFE is more resistant to rupture, which confirms its greater fatigue strength. However, it requires further study by advanced methods.

About the Authors

K. Yu. Klyshnikov
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»
Russian Federation
researcher at the Laboratory of Novel Biomaterials


E. A. Ovcharenko
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»
Russian Federation
PhD, the Head of the Laboratory of Novel Biomaterials


M. A. Rezvova
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»
Russian Federation
research assistant at the Laboratory of Novel Biomaterial


T. V. Glushkova
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»
Russian Federation
PhD, researcher at the Laboratory of Novel Biomaterials


L. S. Barbarash
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»
Russian Federation
PhD, Professor, Academician of the RAS, chief researcher


References

1. Chambers J. Prosthetic heart valves. Int J Clin Pract. 2014; 68(10):1227-1230. doi: 10.1111/ijcp.12309.

2. Manji RA, Ekser B, Menkis AH, Cooper DKC. Bioprosthetic heart valves of the future. Xenotransplantation. 2014;21(1):1-10. doi:10.1111/xen.12080.

3. Singhal P, Adriana L, Butany J. Bioprosthetic Heart Valves: Impact of Implantation on Biomaterials. ISRN Biomaterials. 2013; doi:10.5402/2013/728791

4. Cheung DY, Duan B, Butcher JT. Current progress in tissue engineering of heart valves: multiscale problems, multiscale solutions. Expert Opin Biol Ther. 2015;15(8):1155-72. doi: 10.1517/14712598.2015.1051527

5. Maitz M.F., Applications of synthetic polymers in clinical medicine. Biosurface and Biotribology. 2015; (1) 161–176

6. Ito T., Maekawa A., Yamana K., Yoshizumi T., Sunada M. Use of an Expanded Polytetrafluoroethylene Patch as an Artificial Leaflet in Mitral Valve Plasty: An Early Experience. Ann Thorac Surg. 2010; 89: 1620 – 4.

7. Ando M, Takahashi Y. Ten-year experience with handmade trileaflet polytetrafluoroethylene valved conduit used for pulmonary reconstruction. J Thorac Cardiovasc Surg. 2009; 137: 124-131. doi: 10.1016/j.jtcvs.2008.08.060.

8. Lee C, Lee CH, Kwak JG. Polytetrafluoroethylene bicuspid pulmonary valve replacement: A 5-year experience in 119 patients with congenital heart disease. Ann Thorac Surg. 2016; 102(1): 163-169. doi: 10.1016/j.athoracsur.2016.01.056.

9. Quintessenza JA, Jacobs JP, Chai PJ, Morell VO, Lindberg H. Polytetrafluoroethylene bicuspid pulmonary valve implantation: experience with 126 patients. World J Pediatr Congenit Heart Surg. 2010; 1(1): 20-27. PMID: 23804719. doi: 10.1177/2150135110361509.

10. Bazylev VV, Voevodin AB, Radzhabov DA, Rossejkin EV. The first experience of transapical mitral valve implantation using a “MeDIng” prosthesis. Bjulleten NCSSH im. A.N. Bakuleva RAMN Serdechno-sosudistye zabolevanija. 2016; 17(6): 141. (in Russian).

11. Kudryavtseva Yu.A., Nasonova MV, Burago A.Yu., Akent’eva TN, Zhuravleva I.Yu. Use of nonfractional heparin to prevent the calcification of biomaterial. Siberian Medical Journal (Tomsk). 2010; 25 (2-1): 181-182. (in Russian).

12. Turmanova S, Minchev M, Vassilev K, Danev G. Surface grafting polymerization of vinyl monomers on poly (tetrafluoroethylene) films by plasma treatment. Journal of Polymer Research. 2008; 15(4): 309–318. doi: 10.1007/s10965-007- 9172-0.

13. Gupta B, Plummera C, Bisson I, Frey P, Hilborn J. Plasma-induced graft polymerization of acrylic acid onto poly(ethylene terephthalate) films: characterization and human smoothmuscle cell growthon grafted films. Biomaterials. 2002; 23: 863–871. doi: 10.1016/S0142- 9612(01)00195-8.

14. Nosal M, Poruban R, Valentík P, Sagat M, Nagi AS, Kantorova A. Initial experience with polytetrafluoroethylene leaflet extensions for aortic valve repair. European Journal of Cardio- Thoracic Surgery. 2012; 41: 1255–1258. doi: 10.1093/ ejcts/ezr214.

15. Braunwald NS, Morrow AG. A late evaluation of flexible teflon prostheses utilized for total aortic valve replacement. Postoperative clinical, hemodynamic, and pathological assessments. J Thorac Cardiovasc Surg. 1965; 49: 485-96.

16. Barbarash LS, Odarenko Yu.N., Kokorin SG, Nokhrin AV, Rutkovskaya NV, Borisov VV, Zhuravleva I.Yu. Longterm results of the use of xenobioprostheses treated with epoxy compound in the surgery of atrioventricular defects in young people. Cardiology and cardiovascular surgery. 2012; (5) 2: 77-81. (in Russian).

17. Nasonova MV, Glushkova TV, Borisov VV, Velikanova EA, Burago A.Yu., Kudryavtseva Yu.A. Biocompatibility and structural features of matrices based on biodegradable polymers. Cell technologies in biology and medicine. 2015; 3: 160-166. (in Russian).

18. Rajagopal R. Kowligi R.R., Howard H. Taylor H.H., Stacy A. Wollner S.A., Physical Properties and Testing Methods for PTFE Cardiovascular Patches. Journal of Biomaterials Applications 1993; 7(4):353-61 https://doi. org/10.1177/088532829300700403

19. Ovcharenko E.A., Klyshnikov K.Yu., Glushkova T.V., Nyshtaev D.V., Kudryavtseva Yu.A., Savrasov G.V. Xenopericardial Graft Selection for Valve Apparatus of Transcatheter Heart Valve Bioprosthesis. Biomedical Engineering. 2016; 49(5): 253-257. doi: 10.1007/s10527-016-9543-0.

20. Halevi R, Hamdan A, Marom G, Mega M, Raanani E, Haj-Ali R. Progressive aortic valve calcification: three-dimensional visualization and biomechanical analysis. J Biomech. 2015 Feb 5;48(3):489-97. doi: 10.1016/j.jbiomech.2014.12.004.


Review

For citations:


Klyshnikov K.Yu., Ovcharenko E.A., Rezvova M.A., Glushkova T.V., Barbarash L.S. POTENTIAL BENEFITS FOR USING ePTFE AS A MATERIAL FOR PROSTHETIC HEART VALVES. Complex Issues of Cardiovascular Diseases. 2018;7(2):79-88. (In Russ.) https://doi.org/10.17802/2306-1278-2018-7-2-79-88

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ISSN 2306-1278 (Print)
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