Morphometrical and biomechanical analyses of a stentless bioprosthetic valve: an implication to avoid potential primary tissue failure

Hiroki Takaya, Shinya Masuda, Masaaki Naganuma, Ichiro Yoshioka, Goro Takahashi, Masatoshi Akiyama, Osamu Adachi, Kiichiro Kumagai, Shukei Sugita, Yoshikatsu Saiki

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Stentless bioprosthetic valves provide hemodynamic advantages over stented valves as well as excellent durability. However, some primary tissue failures in bioprostheses have been reported. This study was conducted to evaluate the morphometrical and biomechanical properties of the stentless Medtronic Freestyle™ aortic root bioprosthesis, to identify any arising problem areas, and to speculate on a potential solution. Methods: The three-dimensional heterogeneity of the stentless bioprosthesis wall was investigated using computed tomography. The ascending aorta and the right, left, and non-coronary sinuses of Valsalva were resected and examined by an indentation test to evaluate their biomechanical properties. Results: The non-coronary sinus of Valsalva was significantly thinner than the right sinus of Valsalva (p < 0.01). Young’s modulus, calculated as an indicator of elasticity, was significantly greater at the non-coronary sinus of Valsalva (430.7 ± 374.2 kPa) than at either the left (190.6 ± 70.6 kPa, p < 0.01) or right sinuses of Valsalva (240.0 ± 56.5 kPa, p < 0.05). Conclusions: Based on the morphometrical and biomechanical analyses of the stentless bioprosthesis, we demonstrated that there are differences in wall thickness and elasticity between each sinus of Valsalva. These differences suggest that the non-coronary sinus of Valsalva is the most vulnerable and at greater risk of tissue failure. The exclusion of the non-coronary sinus of Valsalva may be beneficial to mitigate the long-term risks of tissue failure in the stentless bioprosthesis.

Original languageEnglish
Pages (from-to)523-528
Number of pages6
JournalGeneral thoracic and cardiovascular surgery
Volume66
Issue number9
DOIs
Publication statusPublished - 2018 Sep 1

Keywords

  • Aortic root surgery
  • Biomaterials
  • Biomechanical analysis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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