Research progress in geometric configuration design of artificial heart valve_West China Medical Journal

Authors：

LI Yijing ¹ , CHEN Yu ² , LI Tao ¹ , ZHOU Jingyuan ² ,  XIONG Yan ¹

1. School of Mechanical Engineering, Sichuan University, Chengdu, Sichuan 610065, P. R. China;
2. Department of Applied Mechanics, Sichuan University, Chengdu, Sichuan 610065, P. R. China;

Corresponding author：

XIONG Yan, Email: xy@scu.edu.cn

Keywords：

Artificial heart valve; valve geometric configuration; valve design; valve modeling

DOI：

10.7507/1002-0179.202301038

Video：

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Valvular heart disease is a structural or functional disease of the heart due to rheumatic fever, congenital malformation, infection, or trauma, resulting in abnormal cardiac hemodynamics and ultimately heart failure. Implantation of artificial heart valves has become the main way to treat heart valvular disease. Because the structure of the artificial heart valve plays a key role in the stress distribution and hemodynamic performance of the valve and stent, the geometric configuration of the artificial heart valve is constantly updated and improved during its development from mechanical valve to biological valve, which closely mimics the geometric characteristics of the normal natural heart valve. This article sums up the design process of geometric configuration of artificial heart valves and the influence of geometric configuration on the central disc stress and durability of artificial heart valves, analyzes the important parameters of geometric modeling for artificial heart valves, and discusses the development of the corresponding modeling method, to provide reference and new ideas for the biomimetic optimization design of artificial valves.

Citation： LI Yijing, CHEN Yu, LI Tao, ZHOU Jingyuan, XIONG Yan. Research progress in geometric configuration design of artificial heart valve. West China Medical Journal, 2023, 38(9): 1405-1410. doi: 10.7507/1002-0179.202301038 Copy

1.	Li KYC. Bioprosthetic heart valves: upgrading a 50-year old technology. Front Cardiovasc Med, 2019, 6: 47.
2.	Fioretta ES, Motta SE, Lintas V, et al. Next-generation tissue-engineered heart valves with repair, remodelling and regeneration capacity. Nat Rev Cardiol, 2021, 18(2): 92-116.
3.	Kodigepalli KM, Thatcher K, West T, et al. Biology and biomechanics of the heart valve extracellular matrix. J Cardiovasc Dev Dis, 2020, 7(4): 57.
4.	Zakerzadeh R, Hsu MC, Sacks MS. Computational methods for the aortic heart valve and its replacements. Expert Rev Med Devices, 2017, 14(11): 849-866.
5.	Li RL, Russ J, Paschalides C, et al. Mechanical considerations for polymeric heart valve development: biomechanics, materials, design and manufacturing. Biomaterials, 2019, 225: 119493.
6.	Head SJ, Çelik M, Kappetein AP. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28): 2183-2191.
7.	Jana S. Endothelialization of cardiovascular devices. Acta Biomater, 2019, 99: 53-71.
8.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
9.	Ghista DN, Reul H. Optimal prosthetic aortic leaflet valve: design parametric and longevity analyses: development of the Avcothane-51 leaflet valve based on the optimum design analysis. J Biomech, 1977, 10(5/6): 313-324.
10.	Thubrikar M. The aortic valve. New York: Routledge, 2017.
11.	Smuts AN, Blaine DC, Scheffer C, et al. Application of finite element analysis to the design of tissue leaflets for a percutaneous aortic valve. J Mech Behav Biomed Mater, 2011, 4(1): 85-98.
12.	Burriesci G, Marincola FC, Zervides C. Design of a novel polymeric heart valve. J Med Eng Technol, 2010, 34(1): 7-22.
13.	Wheatley DJ, Fisher J, Williams D. Heart valve prosthesis: US, PCT/GB1998/000211. 1998-03-07.
14.	Leat ME, Fisher J. A synthetic leaflet heart valve with improved opening characteristics. Med Eng Phys, 1994, 16(6): 470-476.
15.	Jiang H, Campbell G, Boughner D, et al. Design and manufacture of a polyvinyl alcohol (PVA) cryogel tri-leaflet heart valve prosthesis. Med Eng Phys, 2004, 26(4): 269-277.
16.	Gharaie SH, Morsi Y. A novel design of a polymeric aortic valve. Int J Artif Organs, 2015, 38(5): 259-270.
17.	Lavon K, Halevi R, Marom G, et al. Fluid-structure interaction models of bicuspid aortic valves: the effects of nonfused cusp angles. J Biomech Eng, 2018, 140(3): 031010.
18.	Dehparvar A, Ghanbari J, Zakeri AH. Design and analysis of prosthetic heart valves and assessing the effects of leaflet design on the mechanical attributes of the valves. Front Mech Eng, 2022, 8: 764034.
19.	Xu F, Morganti S, Zakerzadeh R, et al. A framework for designing patient-specific bioprosthetic heart valves using immersogeometric fluid-structure interaction analysis. Int J Numer Method Biomed Eng, 2018, 34(4): e2938.
20.	Abbasi M, Azadani AN. A geometry optimization framework for transcatheter heart valve leaflet design. J Mech Behav Biomed Mater, 2020, 102: 103491.
21.	Gulbulak U, Ertas A, Baturalp TB, et al. The effect of fundamental curves on geometric orifice and coaptation areas of polymeric heart valves. J Mech Behav Biomed Mater, 2020, 112: 104039.
22.	Jermihov PN, Jia L, Sacks MS, et al. Effect of geometry on the leaflet stresses in simulated models of congenital bicuspid aortic valves. Cardiovasc Eng Technol, 2011, 2(1): 48-56.
23.	Claiborne TE, Sheriff J, Kuetting M, et al. In vitro evaluation of a novel hemodynamically optimized trileaflet polymeric prosthetic heart valve. J Biomech Eng, 2013, 135(2): 021021.
24.	Mohammadi H, Mequanint K. Prosthetic aortic heart valves: modeling and design. Med Eng Phys, 2011, 33(2): 131-147.
25.	Salmonsmith J, Tango AM, Ducci A, et al. Haemodynamic issues with transcatheter aortic valve implantation // Giordano A. Transcatheter aortic valve implantation. Cham Springer, 2019: 47-59.
26.	Butterfield M, Wheatley DJ, Williams DF, et al. A new design for polyurethane heart valves. J Heart Valve Dis, 2001, 10(1): 105-110.
27.	Baldwin ACW, Tolis G Jr. Tissue valve degeneration and mechanical valve failure. Curr Treat Options Cardiovasc Med, 2019, 21(7): 33.
28.	Sacks MS, Schoen FJ. Collagen fiber disruption occurs independent of calcification in clinically explanted bioprosthetic heart valves. J Biomed Mater Res, 2002, 62(3): 359-371.
29.	Côté N, Pibarot P, Clavel MA. Incidence, risk factors, clinical impact, and management of bioprosthesis structural valve degeneration. Curr Opin Cardiol, 2017, 32(2): 123-129.
30.	Kostyunin AE, Yuzhalin AE, Rezvova MA, et al. Degeneration of bioprosthetic heart valves: update 2020. J Am Heart Assoc, 2020, 9(19): e018506.
31.	Rassoli A, Fatouraee N, Guidoin R, et al. A comparative study of different tissue materials for bioprosthetic aortic valves using experimental assays and finite element analysis. Comput Methods Programs Biomed, 2022, 220: 106813.
32.	Hsu MC, Kamensky D, Xu F, et al. Dynamic and fluid-structure interaction simulations of bioprosthetic heart valves using parametric design with T-splines and Fung-type material models. Comput Mech, 2015, 55(6): 1211-1225.
33.	Li K, Sun W. Simulated transcatheter aortic valve deformation: a parametric study on the impact of leaflet geometry on valve peak stress. Int J Numer Method Biomed Eng, 2017, 33(3): 10.1002/cnm. 2814.
34.	Hatoum H, Lilly S, Maureira P, et al. The hemodynamics of transcatheter aortic valves in transcatheter aortic valves. J Thorac Cardiovasc Surg, 2021, 161(2): 565-576. e2.
35.	Gaetano F, Bagnoli P, Zaffora A, et al. A newly developed tri-leaflet polymeric heart valve prosthesis. J Mech Med Biol, 2015, 15(2): 1540009.
36.	Balu A, Nallagonda S, Xu F, et al. A deep learning framework for design and analysis of surgical bioprosthetic heart valves. Sci Rep, 2019, 9(1): 18560.
37.	Kouhi E, Morsi YS. A parametric study on mathematical formulation and geometrical construction of a stentless aortic heart valve. J Artif Organs, 2013, 16(4): 425-442.
38.	Izquierdo-Gómez MM, Hernández-Betancor I, García-Niebla J, et al. Valve calcification in aortic stenosis: etiology and diagnostic imaging techniques. Biomed Res Int, 2017, 2017: 5178631.
39.	Auricchio F, Conti M, Morganti S, et al. A computational tool to support pre-operative planning of stentless aortic valve implant. Med Eng Phys, 2011, 33(10): 1183-1192.

1. Li KYC. Bioprosthetic heart valves: upgrading a 50-year old technology. Front Cardiovasc Med, 2019, 6: 47.
2. Fioretta ES, Motta SE, Lintas V, et al. Next-generation tissue-engineered heart valves with repair, remodelling and regeneration capacity. Nat Rev Cardiol, 2021, 18(2): 92-116.
3. Kodigepalli KM, Thatcher K, West T, et al. Biology and biomechanics of the heart valve extracellular matrix. J Cardiovasc Dev Dis, 2020, 7(4): 57.
4. Zakerzadeh R, Hsu MC, Sacks MS. Computational methods for the aortic heart valve and its replacements. Expert Rev Med Devices, 2017, 14(11): 849-866.
5. Li RL, Russ J, Paschalides C, et al. Mechanical considerations for polymeric heart valve development: biomechanics, materials, design and manufacturing. Biomaterials, 2019, 225: 119493.
6. Head SJ, Çelik M, Kappetein AP. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28): 2183-2191.
7. Jana S. Endothelialization of cardiovascular devices. Acta Biomater, 2019, 99: 53-71.
8. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
9. Ghista DN, Reul H. Optimal prosthetic aortic leaflet valve: design parametric and longevity analyses: development of the Avcothane-51 leaflet valve based on the optimum design analysis. J Biomech, 1977, 10(5/6): 313-324.
10. Thubrikar M. The aortic valve. New York: Routledge, 2017.
11. Smuts AN, Blaine DC, Scheffer C, et al. Application of finite element analysis to the design of tissue leaflets for a percutaneous aortic valve. J Mech Behav Biomed Mater, 2011, 4(1): 85-98.
12. Burriesci G, Marincola FC, Zervides C. Design of a novel polymeric heart valve. J Med Eng Technol, 2010, 34(1): 7-22.
13. Wheatley DJ, Fisher J, Williams D. Heart valve prosthesis: US, PCT/GB1998/000211. 1998-03-07.
14. Leat ME, Fisher J. A synthetic leaflet heart valve with improved opening characteristics. Med Eng Phys, 1994, 16(6): 470-476.
15. Jiang H, Campbell G, Boughner D, et al. Design and manufacture of a polyvinyl alcohol (PVA) cryogel tri-leaflet heart valve prosthesis. Med Eng Phys, 2004, 26(4): 269-277.
16. Gharaie SH, Morsi Y. A novel design of a polymeric aortic valve. Int J Artif Organs, 2015, 38(5): 259-270.
17. Lavon K, Halevi R, Marom G, et al. Fluid-structure interaction models of bicuspid aortic valves: the effects of nonfused cusp angles. J Biomech Eng, 2018, 140(3): 031010.
18. Dehparvar A, Ghanbari J, Zakeri AH. Design and analysis of prosthetic heart valves and assessing the effects of leaflet design on the mechanical attributes of the valves. Front Mech Eng, 2022, 8: 764034.
19. Xu F, Morganti S, Zakerzadeh R, et al. A framework for designing patient-specific bioprosthetic heart valves using immersogeometric fluid-structure interaction analysis. Int J Numer Method Biomed Eng, 2018, 34(4): e2938.
20. Abbasi M, Azadani AN. A geometry optimization framework for transcatheter heart valve leaflet design. J Mech Behav Biomed Mater, 2020, 102: 103491.
21. Gulbulak U, Ertas A, Baturalp TB, et al. The effect of fundamental curves on geometric orifice and coaptation areas of polymeric heart valves. J Mech Behav Biomed Mater, 2020, 112: 104039.
22. Jermihov PN, Jia L, Sacks MS, et al. Effect of geometry on the leaflet stresses in simulated models of congenital bicuspid aortic valves. Cardiovasc Eng Technol, 2011, 2(1): 48-56.
23. Claiborne TE, Sheriff J, Kuetting M, et al. In vitro evaluation of a novel hemodynamically optimized trileaflet polymeric prosthetic heart valve. J Biomech Eng, 2013, 135(2): 021021.
24. Mohammadi H, Mequanint K. Prosthetic aortic heart valves: modeling and design. Med Eng Phys, 2011, 33(2): 131-147.
25. Salmonsmith J, Tango AM, Ducci A, et al. Haemodynamic issues with transcatheter aortic valve implantation // Giordano A. Transcatheter aortic valve implantation. Cham Springer, 2019: 47-59.
26. Butterfield M, Wheatley DJ, Williams DF, et al. A new design for polyurethane heart valves. J Heart Valve Dis, 2001, 10(1): 105-110.
27. Baldwin ACW, Tolis G Jr. Tissue valve degeneration and mechanical valve failure. Curr Treat Options Cardiovasc Med, 2019, 21(7): 33.
28. Sacks MS, Schoen FJ. Collagen fiber disruption occurs independent of calcification in clinically explanted bioprosthetic heart valves. J Biomed Mater Res, 2002, 62(3): 359-371.
29. Côté N, Pibarot P, Clavel MA. Incidence, risk factors, clinical impact, and management of bioprosthesis structural valve degeneration. Curr Opin Cardiol, 2017, 32(2): 123-129.
30. Kostyunin AE, Yuzhalin AE, Rezvova MA, et al. Degeneration of bioprosthetic heart valves: update 2020. J Am Heart Assoc, 2020, 9(19): e018506.
31. Rassoli A, Fatouraee N, Guidoin R, et al. A comparative study of different tissue materials for bioprosthetic aortic valves using experimental assays and finite element analysis. Comput Methods Programs Biomed, 2022, 220: 106813.
32. Hsu MC, Kamensky D, Xu F, et al. Dynamic and fluid-structure interaction simulations of bioprosthetic heart valves using parametric design with T-splines and Fung-type material models. Comput Mech, 2015, 55(6): 1211-1225.
33. Li K, Sun W. Simulated transcatheter aortic valve deformation: a parametric study on the impact of leaflet geometry on valve peak stress. Int J Numer Method Biomed Eng, 2017, 33(3): 10.1002/cnm. 2814.
34. Hatoum H, Lilly S, Maureira P, et al. The hemodynamics of transcatheter aortic valves in transcatheter aortic valves. J Thorac Cardiovasc Surg, 2021, 161(2): 565-576. e2.
35. Gaetano F, Bagnoli P, Zaffora A, et al. A newly developed tri-leaflet polymeric heart valve prosthesis. J Mech Med Biol, 2015, 15(2): 1540009.
36. Balu A, Nallagonda S, Xu F, et al. A deep learning framework for design and analysis of surgical bioprosthetic heart valves. Sci Rep, 2019, 9(1): 18560.
37. Kouhi E, Morsi YS. A parametric study on mathematical formulation and geometrical construction of a stentless aortic heart valve. J Artif Organs, 2013, 16(4): 425-442.
38. Izquierdo-Gómez MM, Hernández-Betancor I, García-Niebla J, et al. Valve calcification in aortic stenosis: etiology and diagnostic imaging techniques. Biomed Res Int, 2017, 2017: 5178631.
39. Auricchio F, Conti M, Morganti S, et al. A computational tool to support pre-operative planning of stentless aortic valve implant. Med Eng Phys, 2011, 33(10): 1183-1192.

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