Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue

Background: Porcine heart and bovine pericardium valves, which are collagen-based with relatively little elastin, have been broadly utilized to construct bioprosthetic heart valves (BHVs). With a larger proportion of elastin, the pulmonary visceral pleura (PVP) has greater elasticity and could poten...

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Main Authors: Ye Chen, Xiao Lu, Haoxiang Luo, Ghassan S. Kassab
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Bioengineering and Biotechnology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fbioe.2022.869095/full
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author Ye Chen
Xiao Lu
Haoxiang Luo
Ghassan S. Kassab
author_facet Ye Chen
Xiao Lu
Haoxiang Luo
Ghassan S. Kassab
author_sort Ye Chen
collection DOAJ
description Background: Porcine heart and bovine pericardium valves, which are collagen-based with relatively little elastin, have been broadly utilized to construct bioprosthetic heart valves (BHVs). With a larger proportion of elastin, the pulmonary visceral pleura (PVP) has greater elasticity and could potentially serve as an advantageous biomaterial for the construction/repair of BHVs. The question of how the aortic valve’s performance is affected by its bending rigidity has not been well studied.Methods: Based on the stress–strain relationships of the pericardium and PVP determined by planar uni-axial tests, a three-dimensional (3D) computational fluid–structure interaction (FSI) framework is employed to numerically investigate the aortic valve’s performance by considering three different cases with Young’s modulus as follows: E=375, 750, and 1500 kPa, respectively.Results: The stroke volumes are 112, 99.6, and 91.4 ml as Young’s modulus increases from 375 to 750 and 1500 kPa, respectively. Peak geometric opening area (GOA) values are 2.3, 2.2, and 2.0 cm2 for E=375, 750, and 1500 kPa, respectively. The maximum value of the aortic leaflet stress is about 271 kPa for E=375 kPa, and it increases to about 383 and 540 kPa for E=750 and 1500 kPa in the belly region at the peak systole, while it reduces from 550 kPa to 450 and 400 kPa for E=375, 750, and 1500 kPa, respectively, at the instant of peak “water-hammer”.Conclusion: A more compliant PVP aortic leaflet valve with a smaller Young’s modulus, E, has a higher cardiac output, larger GOA, and lower hemodynamic resistance. Most importantly, the aortic leaflet stresses are substantially lower in the belly region within the higher compliance PVP aortic valve tissue during the systole phase, even though some stress increase is also found during the fast-closing phase due to the “water-hammer” effect similar to that in the pericardial tissue. Future clinical studies will be conducted to test the hypothesis that the PVP-based valve leaflets with higher compliance will have lower fatigue or calcification rates due to the overall lower stress.
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spelling doaj.art-312f4ae4960f4135884ae7c74f777ede2022-12-22T02:22:14ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-04-011010.3389/fbioe.2022.869095869095Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial TissueYe Chen0Xiao Lu1Haoxiang Luo2Ghassan S. Kassab3California Medical Innovations Institute, San Diego, CA, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United StatesDepartment of Mechanical Engineering, Vanderbilt University, Nashville, TN, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United StatesBackground: Porcine heart and bovine pericardium valves, which are collagen-based with relatively little elastin, have been broadly utilized to construct bioprosthetic heart valves (BHVs). With a larger proportion of elastin, the pulmonary visceral pleura (PVP) has greater elasticity and could potentially serve as an advantageous biomaterial for the construction/repair of BHVs. The question of how the aortic valve’s performance is affected by its bending rigidity has not been well studied.Methods: Based on the stress–strain relationships of the pericardium and PVP determined by planar uni-axial tests, a three-dimensional (3D) computational fluid–structure interaction (FSI) framework is employed to numerically investigate the aortic valve’s performance by considering three different cases with Young’s modulus as follows: E=375, 750, and 1500 kPa, respectively.Results: The stroke volumes are 112, 99.6, and 91.4 ml as Young’s modulus increases from 375 to 750 and 1500 kPa, respectively. Peak geometric opening area (GOA) values are 2.3, 2.2, and 2.0 cm2 for E=375, 750, and 1500 kPa, respectively. The maximum value of the aortic leaflet stress is about 271 kPa for E=375 kPa, and it increases to about 383 and 540 kPa for E=750 and 1500 kPa in the belly region at the peak systole, while it reduces from 550 kPa to 450 and 400 kPa for E=375, 750, and 1500 kPa, respectively, at the instant of peak “water-hammer”.Conclusion: A more compliant PVP aortic leaflet valve with a smaller Young’s modulus, E, has a higher cardiac output, larger GOA, and lower hemodynamic resistance. Most importantly, the aortic leaflet stresses are substantially lower in the belly region within the higher compliance PVP aortic valve tissue during the systole phase, even though some stress increase is also found during the fast-closing phase due to the “water-hammer” effect similar to that in the pericardial tissue. Future clinical studies will be conducted to test the hypothesis that the PVP-based valve leaflets with higher compliance will have lower fatigue or calcification rates due to the overall lower stress.https://www.frontiersin.org/articles/10.3389/fbioe.2022.869095/fullaortic valvecardiovascular flowfluid–structure interactionleaflet stressestissue stiffness
spellingShingle Ye Chen
Xiao Lu
Haoxiang Luo
Ghassan S. Kassab
Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
Frontiers in Bioengineering and Biotechnology
aortic valve
cardiovascular flow
fluid–structure interaction
leaflet stresses
tissue stiffness
title Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
title_full Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
title_fullStr Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
title_full_unstemmed Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
title_short Aortic Leaflet Stresses Are Substantially Lower Using Pulmonary Visceral Pleura Than Pericardial Tissue
title_sort aortic leaflet stresses are substantially lower using pulmonary visceral pleura than pericardial tissue
topic aortic valve
cardiovascular flow
fluid–structure interaction
leaflet stresses
tissue stiffness
url https://www.frontiersin.org/articles/10.3389/fbioe.2022.869095/full
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