In Vitro Study of a Stentless Aortic Bioprosthesis Made of Bacterial Cellulose
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Cardiovascular Engineering and Technology (Ó 2020) https://doi.org/10.1007/s13239-020-00500-z
Original Article
In Vitro Study of a Stentless Aortic Bioprosthesis Made of Bacterial Cellulose KINGA DAWIDOWSKA
,1 PIOTR SIONDALSKI,2 and MAGDALENA KOłACZKOWSKA2
1
Medical Engineering Division, Maritime Advanced Research Centre, Szczecin´ska 65, 80-392 Gdan´sk, Poland; and 2Cardiac and Vascular Surgery Department, Medical University of Gdan´sk, De˛binki 7, 80-211 Gdan´sk, Poland (Received 19 March 2020; accepted 5 November 2020) Associate Editor Hwa Liang Leo oversaw the review of this article.
Abstract Purpose—The paper present findings from an in vitro experimental study of a stentless human aortic bioprosthesis (HAB) made of bacterial cellulose (BC). Three variants of the basic model were designed and tested to identify the valve prosthesis with the best performance parameters. The modified models were made of BC, and the basic model of pericardium. Methods—Each model (named V1, V2 and V3) was implanted into a 90 mm porcine aorta. Effective Orifice Area (EOA), rapid valve opening time (RVOT) and rapid valve closing time (RVCT) were determined. The flow resistance of each bioprosthesis model during the simulated heart systole, i.e. for the mean differential pressure (DP) at the time of full valve opening was measured. All experimental specimens were exposed to a mean blood pressure (MBP) of 90.5 ± 2.3 mmHg. Results—The V3 model demonstrated the best performance. The index defining the maximum opening of the bioprosthesis during systole for models V1, V2 and V3 was 2.67 ± 0.59, 2.04 ± 0.23 and 2.85 ± 0.59 cm2, respectively. The mean flow rate through the V3 valve was 5.7 ± 1, 6.9 ± 0.7 and 8.9 ± 1.4 l/min for stroke volume (SV) of 65, 90 and 110 mL, respectively. The phase of immediate opening and closure for models V1, V2 and V3 was 8, 7 and 5% of the cycle duration, respectively. The mean flow resistance of the models was: 4.07 ± 2.1, 4.28 ± 2.51 and 5.6 ± 2.32 mmHg. Conclusions—The V3 model of the aortic valve prosthesis is the most effective. In vivo tests using BC as a structural material for this model are recommended. The response time of the V3 model to changed work conditions is comparable to
Address correspondence to Kinga Dawidowska, Medical Engineering Division, Maritime Advanced Research Centre, Szczecin´ska 65, 80392 Gdan´sk, Poland. Electronic mail: [email protected]
that of a healthy human heart. The model functions as an aortic valve prosthesis in in vitro conditions. Keywords—Human aortic bioprosthesis, HAB, Aortic valve prosthesis, Aortic bioprosthesis, Bacterial cellulose, Nanocelulose.
INTRODUCTION The rate of aortic valve replacement (AVR) surgeries is growing each year. In the United States between 1999 and 2011 this rate increased on average by 1.6%, and the number of surgical AVRs for elderly patients was also on the rise.37 Moreover, during this 13-year-long observation, the number of mechanical prosthetic implants decreased in the US by 28.6% in favour of bioprosthesis implants,37 a
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