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Current Directions in Biomedical Engineering

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Buzug, Thorsten M. / Haueisen, Jens / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Kraft, Marc / Lenarz, Thomas / Leonhardt, Steffen / Malberg, Hagen / Penzel, Thomas / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Urban, Gerald A.


CiteScore 2018: 0.47

Source Normalized Impact per Paper (SNIP) 2018: 0.377

Open Access
Online
ISSN
2364-5504
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Influence of leaflet geometry on hydrodynamic performance of transcatheter aortic valve prostheses

Kaule Sebastian
  • Corresponding author
  • Institute for ImplantTechnology and Biomaterials e.V., Friedrich-Barnewitz- Str. 4, Rostock- Warnemünde, Germany
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/ Pfensig Sylvia / Siewert Stefan / Sylvia Pfensig / Stefan Siewert / Klaus-Peter Schmitz
  • Institute for ImplantTechnology and Biomaterials e.V., Rostock- Warnemünde, Germany
  • Institute for Biomedical Engineering, Rostock University Medical Center, Rostock- Warnemünde, Germany
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/ Michael Stiehm / Kohse Stefanie
  • Institute for Biomedical Engineering, Rostock University Medical Center, Rostock- Warnemünde, Germany
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/ Grabow Niels
  • Institute for Biomedical Engineering, Rostock University Medical Center, Rostock- Warnemünde, Germany
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/ Öner Alper
Published Online: 2019-09-18 | DOI: https://doi.org/10.1515/cdbme-2019-0119

Abstract

The implantation of transcatheter aortic valve prostheses (TAVP) for therapy of aortic valve stenosis shows more and more clinically non-inferiority results compared to surgical valve replacement in intermediate and low risk patients. Commonly clinically used TAVP are manufactured from chemically fixed xenograft leaflet material, e.g. bovine or porcine pericardium. While the clinical use of TAVP currently extends, challenges concerning valve durability and leaflet calcification have to be addressed. In this regard, artificial leaflet materials represent a promising option for a next generation of TAVP. As a first step for the development of TAVP from polymeric nonwoven, the aim of this study was to determine the influence of leaflet geometry on hydrodynamic performance of TAVP prototypes. Based on a parametric model of the valve leaflets, we varied the curvature of the belly line forming the leaflet coaptation area from an initial, quite concave, leaflet geometry with a value of 0.5° to an almost straight geometry for the leaflets with a value 0.15°. Manufacturing of TAVP prototypes was conducted by means of electrospinning technique with a polycarbonate based silicone elastomer. Hydrodynamic characterization according to ISO 5840-3 standards was performed using a pulse duplicator system with a heart rate of 70 BPM, systolic duration of 35%, mean aortic pressure of 100 mmHg and a stroke volume of 96 ml. Cardiac output as well as mean transaortic pressure gradient, closing volume, leakage volume and regurgitation were measured to compare the different leaflet geometries. To summarize, the curvature of the leaflets’ belly has a crucial impact on TAVP hydrodynamics under physiological test conditions. In particular, the opening and closing behavior is strongly influenced by a steeper curvature leading to larger closing volumes and higher regurgitant fractions. Further studies are planned to identify an optimum with respect to leaflet material selection, leaflet geometry and hydrodynamic properties of TAVP.

Keywords: transcatheter aortic valve; hydrodynamic testing; valve geometry

About the article

Published Online: 2019-09-18

Published in Print: 2019-09-01


Citation Information: Current Directions in Biomedical Engineering, Volume 5, Issue 1, Pages 473–475, ISSN (Online) 2364-5504, DOI: https://doi.org/10.1515/cdbme-2019-0119.

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© 2019 by Walter de Gruyter Berlin/Boston. This work is licensed under the Creative Commons Attribution 4.0 Public License. BY 4.0

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