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Rassoli A, Li Y, Bao X, Kawecki F, Zhao X, Chappard D, Le-Bel G, Feng J, Weber B, Fatouraee N, Zhang Z, Jing Z, Germain L, Wang L, Guidoin R. Donkey pericardium as a select sourcing to manufacture percutaneous heart valves: Decellularization has not yet demonstrated any clear cut advantage to glutaraldehyde treatment. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2019. [DOI: 10.1016/j.medntd.2020.100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Meng S, Mao J, Rouse EN, Le-Bel G, Bourget JM, Reed RR, Philippe E, How D, Zhang Z, Germain L, Guidoin R. The Red Kangaroo pericardium as a material source for the manufacture of percutaneous heart valves. Morphologie 2019; 103:37-47. [PMID: 30638803 DOI: 10.1016/j.morpho.2018.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The kangaroo pericardium might be considered to be a good candidate material for use in the manufacture of the leaflets of percutaneous heart valves based upon the unique lifestyle. The diet consists of herbs, forbs and strubs. The kangaroo pericardium holds an undulated structure of collagen. MATERIAL AND METHOD A Red Kangaroo was obtained after a traffic fatality and the pericardium was dissected. Four compasses were cut from four different sites: auricular (AUR), atrial (ATR), sternoperitoneal (SPL) and phrenopericardial (PPL). They were investigated by means of scanning electron microscopy, light microscopy and transmission electron microscopy. RESULTS All the samples showed dense and wavy collagen bundles without vascularisation from both the epicardium and the parietal pericardium. The AUR and the ATR were 150±25μm thick whereas the SPL and the PPL were thinner at 120±20μm. The surface of the epicardium was smooth and glistening. The filaments of collagen were well individualized without any aggregation, but the banding was poorly defined and somewhat blurry. CONCLUSION This detailed morphological analysis of the kangaroo pericardium illustrated a surface resistant to thrombosis and physical characteristics resistant to fatigue. The morphological characteristics of the kangaroo pericardium indicate that it represents an outstanding alternative to the current sources e.g., bovine and porcine. However, procurement of tissues from the wild raises supply and sanitary issues. Health concerns based upon sanitary uncertainty and reliability of supply of wild animals remain real problems.
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Affiliation(s)
- S Meng
- Chongqing Key Lab of Catalysis and Functional Organic Molecules; College of Environment and Biotechnology, Chongqing Technology and Business University, Chongqing, PR China
| | - J Mao
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - E N Rouse
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - G Le-Bel
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - J M Bourget
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R R Reed
- Department of Comparative Medicine, College of Veterinary of Tennessee, Knoxville, TN, USA
| | - E Philippe
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - D How
- Peninsula College of Medicine and Dentistry (PCMD), Plymouth, Devon, UK
| | - Z Zhang
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - L Germain
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada
| | - R Guidoin
- Axe Médecine Régénératrice, Centre de Recherche du CHU and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec Canada.
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Rotman OM, Bianchi M, Ghosh RP, Kovarovic B, Bluestein D. Principles of TAVR valve design, modelling, and testing. Expert Rev Med Devices 2018; 15:771-791. [PMID: 30318937 DOI: 10.1080/17434440.2018.1536427] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Transcatheter aortic valve replacement (TAVR) has emerged as an effective minimally-invasive alternative to surgical valve replacement in medium- to high-risk, elderly patients with calcific aortic valve disease and severe aortic stenosis. The rapid growth of the TAVR devices market has led to a high variety of designs, each aiming to address persistent complications associated with TAVR valves that may hamper the anticipated expansion of TAVR utility. AREAS COVERED Here we outline the challenges and the technical demands that TAVR devices need to address for achieving the desired expansion, and review design aspects of selected, latest generation, TAVR valves of both clinically-used and investigational devices. We further review in detail some of the up-to-date modeling and testing approaches for TAVR, both computationally and experimentally, and additionally discuss those as complementary approaches to the ISO 5840-3 standard. A comprehensive survey of the prior and up-to-date literature was conducted to cover the most pertaining issues and challenges that TAVR technology faces. EXPERT COMMENTARY The expansion of TAVR over SAVR and to new indications seems more promising than ever. With new challenges to come, new TAV design approaches, and materials used, are expected to emerge, and novel testing/modeling methods to be developed.
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Affiliation(s)
- Oren M Rotman
- a Department of Biomedical Engineering , Stony Brook University , Stony Brook , NY , USA
| | - Matteo Bianchi
- a Department of Biomedical Engineering , Stony Brook University , Stony Brook , NY , USA
| | - Ram P Ghosh
- a Department of Biomedical Engineering , Stony Brook University , Stony Brook , NY , USA
| | - Brandon Kovarovic
- a Department of Biomedical Engineering , Stony Brook University , Stony Brook , NY , USA
| | - Danny Bluestein
- a Department of Biomedical Engineering , Stony Brook University , Stony Brook , NY , USA
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Convelbo C, El Hafci H, Petite H, Zegdi R. Traumatic leaflet injury: comparison of porcine leaflet self-expandable and bovine leaflet balloon-expandable prostheses. Eur J Cardiothorac Surg 2017; 53:1062-1067. [DOI: 10.1093/ejcts/ezx451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/18/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Channing Convelbo
- CNRS UMR 7052 Osteo-Articular Bioengineering and Bioimaging Laboratory (B2OA), Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Hanane El Hafci
- CNRS UMR 7052 Osteo-Articular Bioengineering and Bioimaging Laboratory (B2OA), Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Hervé Petite
- CNRS UMR 7052 Osteo-Articular Bioengineering and Bioimaging Laboratory (B2OA), Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Rachid Zegdi
- Paris-Est Créteil University (Paris XII), Créteil, France
- AP-HP, Henri Mondor Hospital, Créteil, France
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Guidoin R, Zegdi R, Lin J, Mao J, Rochette-Drouin O, How D, Guan X, Bruneval P, Wang L, Germain L, Zhang Z. Transcatheter heart valve crimping and the protecting effects of a polyester cuff. Morphologie 2016; 100:234-244. [PMID: 27461102 DOI: 10.1016/j.morpho.2016.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Prior to deployment, the percutaneous heart valves must be crimped and loaded into sheaths of diameters that can be as low as 6mm for a 23mm diameter valve. However, as the valve leaflets are fragile, any damage caused during this crimping process may contribute to reducing its long-term durability in vivo. MATERIAL AND METHOD Bovine pericardium percutaneous valves were manufactured as follows. The leaflets were sutured on a nitinol frame. A polyester cuff fabric served as a buffer between the pericardium and the stent. Two valves were crimped and one valve was used as control. The valves were examined in gross observation and micro-CT scan and then the leaflets were processed for histology and analyzed in scanning electron microscopy, light microscopy and transmission electron microscopy. RESULT Crimping of the valves resulted in the increase thickness of the leaflets and there was no evidence of additional delamination. The heavy prints of the stents were irregularly distributed on the outflow surface in the crimped devices and were shallow and did not penetrate throughout the thickness of the leaflets. However, the wavy microscopy of collagen fiber bundles was well preserved. They were found to remain individualized without any agglutination as shown by the regular banding appearance. CONCLUSION Crimping of self-deployable valves per se caused only minor damages to the leaflets. However, the procedure could be refined in order to minimize areas of high pressure and swelling of the tissue that can be accompanied with flow surface disruption and increase of the hydraulic conductance. The incorporation of a polyester buffer serves to prevent the deleterious effects that may be caused if the pericardium tissue were in direct contact with the nitinol stent.
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Affiliation(s)
- R Guidoin
- Department of surgery, faculty of medicine, Laval university and axe médecine régénérative, centre de recherche, CHU, Vandry building, 2325, rue de l'Université, GIV OA6 Québec, Canada.
| | - R Zegdi
- Services de chirurgie cardiovasculaire et de pathologie, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - J Lin
- Key laboratory of textile science and technology of Ministry of Education and College of Textile, Donghua university, Shanghai, China
| | - J Mao
- Department of surgery, faculty of medicine, Laval university and axe médecine régénérative, centre de recherche, CHU, Vandry building, 2325, rue de l'Université, GIV OA6 Québec, Canada
| | - O Rochette-Drouin
- Department of surgery, faculty of medicine, Laval university and axe médecine régénérative, centre de recherche, CHU, Vandry building, 2325, rue de l'Université, GIV OA6 Québec, Canada
| | - D How
- Peninsula school of medicine and dentistry, Plymouth, Devon, United Kingdom
| | - X Guan
- Key laboratory of textile science and technology of Ministry of Education and College of Textile, Donghua university, Shanghai, China
| | - P Bruneval
- Services de chirurgie cardiovasculaire et de pathologie, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - L Wang
- Key laboratory of textile science and technology of Ministry of Education and College of Textile, Donghua university, Shanghai, China
| | - L Germain
- Department of surgery, faculty of medicine, Laval university and axe médecine régénérative, centre de recherche, CHU, Vandry building, 2325, rue de l'Université, GIV OA6 Québec, Canada
| | - Z Zhang
- Department of surgery, faculty of medicine, Laval university and axe médecine régénérative, centre de recherche, CHU, Vandry building, 2325, rue de l'Université, GIV OA6 Québec, Canada
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Permanyer E, Estigarribia AJ, Ysasi A, Herrero E, Semper O, Llorens R. The 3f Enable sutureless bioprosthesis: Early results, safeguards, and pitfalls. J Thorac Cardiovasc Surg 2015; 149:1578-83. [DOI: 10.1016/j.jtcvs.2014.10.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 06/24/2014] [Accepted: 10/06/2014] [Indexed: 11/15/2022]
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Kheradvar A, Groves EM, Goergen CJ, Alavi SH, Tranquillo R, Simmons CA, Dasi LP, Grande-Allen KJ, Mofrad MRK, Falahatpisheh A, Griffith B, Baaijens F, Little SH, Canic S. Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement. Ann Biomed Eng 2014; 43:844-57. [DOI: 10.1007/s10439-014-1191-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/13/2014] [Indexed: 11/29/2022]
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Percutaneous pulmonary valve endocarditis: Incidence, prevention and management. Arch Cardiovasc Dis 2014; 107:615-24. [DOI: 10.1016/j.acvd.2014.07.052] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/15/2014] [Accepted: 07/23/2014] [Indexed: 02/07/2023]
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