Mechanical behaviors of high-strength fabric composite membrane designed for cardiac valve prosthesis replacement

J Mech Behav Biomed Mater. 2023 Jun;142:105863. doi: 10.1016/j.jmbbm.2023.105863. Epub 2023 Apr 17.

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.

PMID:37116312 | DOI:10.1016/j.jmbbm.2023.105863

The efficacy of three-ball breathing apparatus exercise based on the concept of pulmonary rehabilitation in patients after lung cancer surgery

Postoperative patients with lung cancer mostly experience different degrees of dyspnea and decreased activity tolerance, and these symptoms all significantly affect postoperative quality of life. The concept o…  Read More

The efficacy of three-ball breathing apparatus exercise based on the concept of pulmonary rehabilitation in patients after lung cancer surgery

Postoperative patients with lung cancer mostly experience different degrees of dyspnea and decreased activity tolerance, and these symptoms all significantly affect postoperative quality of life. The concept o…  Read More

Risk factors for postoperative myocardial injury-related cardiogenic shock in patients undergoing cardiac surgery

Myocardial injury-related cardiogenic shock (MICS) is significantly associated with poor outcomes in patients after cardiac surgery. Herein, we aimed to investigate the risk factor for postoperative MICS.

Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study

Prevention, screening, and early treatment are the aims of postoperative delirium management. The scoring system is an objective and effective tool to stratify potential delirium risk for patients undergoing c…  Read More

The efficacy of three-ball breathing apparatus exercise based on the concept of pulmonary rehabilitation in patients after lung cancer surgery

Postoperative patients with lung cancer mostly experience different degrees of dyspnea and decreased activity tolerance, and these symptoms all significantly affect postoperative quality of life. The concept o…  Read More

Preoperative computed tomography-guided transscapular sens-cure needle localization for pulmonary nodule located behind the scapula

Video-assisted thoracoscopic surgery (VATS) is an approach that is commonly used to resect pulmonary nodules (PNs). However, when these PNs are located behind the scapula, a transscapular access approach is ge…  Read More

Calcification of Various Bioprosthetic Materials in Rats: Is It Really Different?

Int J Mol Sci. 2023 Apr 14;24(8):7274. doi: 10.3390/ijms24087274.

ABSTRACT

The causes of heart valve bioprosthetic calcification are still not clear. In this paper, we compared the calcification in the porcine aorta (Ao) and the bovine jugular vein (Ve) walls, as well as the bovine pericardium (Pe). Biomaterials were crosslinked with glutaraldehyde (GA) and diepoxide (DE), after which they were implanted subcutaneously in young rats for 10, 20, and 30 days. Collagen, elastin, and fibrillin were visualized in non-implanted samples. Atomic absorption spectroscopy, histological methods, scanning electron microscopy, and Fourier-transform infrared spectroscopy were used to study the dynamics of calcification. By the 30th day, calcium accumulated most intensively in the collagen fibers of the GA-Pe. In elastin-rich materials, calcium deposits were associated with elastin fibers and localized differences in the walls of Ao and Ve. The DE-Pe did not calcify at all for 30 days. Alkaline phosphatase does not affect calcification since it was not found in the implant tissue. Fibrillin surrounds elastin fibers in the Ao and Ve, but its involvement in calcification is questionable. In the subcutaneous space of young rats, which are used to model the implants’ calcification, the content of phosphorus was five times higher than in aging animals. We hypothesize that the centers of calcium phosphate nucleation are the positively charged nitrogen of the pyridinium rings, which is the main one in fresh elastin and appears in collagen as a result of GA preservation. Nucleation can be significantly accelerated at high concentrations of phosphorus in biological fluids. The hypothesis needs further experimental confirmation.

PMID:37108443 | PMC:PMC10139218 | DOI:10.3390/ijms24087274

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Great saphenous vein is a conduit commonly used for coronary artery bypass grafting. However, several complications could occur at leg wound site for vein harvesting. Here, we describe a huge sac of hematoma a…  Read More