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Nichay NR, Dokuchaeva AA, Kulyabin YY, Boyarkin EV, Kuznetsova EV, Rusakova YL, Murashov IS, Vaver AA, Bogachev-Prokophiev AV, Zhuravleva IY. Epoxy- versus Glutaraldehyde-Treated Bovine Jugular Vein Conduit for Pulmonary Valve Replacement: A Comparison of Morphological Changes in a Pig Model. Biomedicines 2023; 11:3101. [PMID: 38002101 PMCID: PMC10669752 DOI: 10.3390/biomedicines11113101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Valved conduits are often required to replace pulmonary arteries (PA). A widely used Contegra device is made of bovine jugular vein (BJV), preserved with glutaraldehyde (GA) and iso-propanol. However, it has several drawbacks that may be attributed to its chemical treatment. We hypothesized that the use of an alternative preservation compound may significantly improve BJV conduit performance. This study aimed to compare the macroscopic and microscopic properties of the BJV treated with diepoxide (DE) and GA in a porcine model. Twelve DE-BJVs and four Contegra conduits were used for PA replacement in minipigs. To assess the isolated influence of GA, we included an additional control group-BJV treated with 0.625% GA (n = 4). The animals were withdrawn after 6 months of follow-up and the conduits were examined. Explanted DE-BJV had a soft elastic wall with no signs of thrombosis or calcification and good conduit integration, including myofibroblast germination, an ingrowth of soft connective tissue formations and remarkable neoangiogenesis. The inner surface of DE-BJVs was covered by a thin neointimal layer with a solid endothelium. Contegra grafts had a stiffer wall with thrombosis on the leaflets. Calcified foci, chondroid metaplasia, and hyalinosis were observed within the wall. The distal anastomotic sites had hyperplastic neointima, partially covered with the endothelium. The wall of GA-BJV was stiff and rigid with degenerative changes, a substantial amount of calcium deposits and dense fibrotic formations in adventitia. An irregular neointimal layer was presented in the anastomotic sites without endothelial cover in the GA BJV wall. These results demonstrate that DE treatment improves conduit integration and the endothelialization of the inner surface while preventing the mineralization of the BJV, which may reduce the risk of early conduit dysfunction.
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Affiliation(s)
- Nataliya R. Nichay
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
- Cardiovascular Department, Novosibirsk State Medical University, Ministry of Health of Russian Federation, 52 Krasny Prospect, Novosibirsk 630091, Russia
| | - Anna A. Dokuchaeva
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Yuriy Yu. Kulyabin
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Evgeniy V. Boyarkin
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Elena V. Kuznetsova
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Yanina L. Rusakova
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Ivan S. Murashov
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Andrey A. Vaver
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Alexander V. Bogachev-Prokophiev
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Irina Yu. Zhuravleva
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
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Toma M, Singh-Gryzbon S, Frankini E, Wei Z(A, Yoganathan AP. Clinical Impact of Computational Heart Valve Models. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3302. [PMID: 35591636 PMCID: PMC9101262 DOI: 10.3390/ma15093302] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 12/17/2022]
Abstract
This paper provides a review of engineering applications and computational methods used to analyze the dynamics of heart valve closures in healthy and diseased states. Computational methods are a cost-effective tool that can be used to evaluate the flow parameters of heart valves. Valve repair and replacement have long-term stability and biocompatibility issues, highlighting the need for a more robust method for resolving valvular disease. For example, while fluid-structure interaction analyses are still scarcely utilized to study aortic valves, computational fluid dynamics is used to assess the effect of different aortic valve morphologies on velocity profiles, flow patterns, helicity, wall shear stress, and oscillatory shear index in the thoracic aorta. It has been analyzed that computational flow dynamic analyses can be integrated with other methods to create a superior, more compatible method of understanding risk and compatibility.
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Affiliation(s)
- Milan Toma
- Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, P.O. Box 8000, Old Westbury, NY 11568, USA;
| | - Shelly Singh-Gryzbon
- Wallace H. Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (S.S.-G.); (A.P.Y.)
| | - Elisabeth Frankini
- Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, P.O. Box 8000, Old Westbury, NY 11568, USA;
| | - Zhenglun (Alan) Wei
- Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Ajit P. Yoganathan
- Wallace H. Coulter School of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (S.S.-G.); (A.P.Y.)
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Computational Analysis of the Pulmonary Arteries in Congenital Heart Disease: A Review of the Methods and Results. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:2618625. [PMID: 33868449 PMCID: PMC8035004 DOI: 10.1155/2021/2618625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/25/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022]
Abstract
With the help of computational fluid dynamics (CFD), hemodynamics of the pulmonary arteries (PA's) can be studied in detail and varying physiological circumstances and treatment options can be simulated. This offers the opportunity to improve the diagnostics and treatment of PA stenosis in biventricular congenital heart disease (CHD). The aim of this review was to evaluate the methods of computational studies for PA's in biventricular CHD and the level of validation of the numerical outcomes. A total of 34 original research papers were selected. The literature showed a great variety in the used methods for (re) construction of the geometry as well as definition of the boundary conditions and numerical setup. There were 10 different methods identified to define inlet boundary conditions and 17 for outlet boundary conditions. A total of nine papers verified their CFD outcomes by comparing results to clinical data or by an experimental mock loop. The diversity in used methods and the low level of validation of the outcomes result in uncertainties regarding the reliability of numerical studies. This limits the current clinical utility of CFD for the study of PA flow in CHD. Standardization and validation of the methods are therefore recommended.
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Personalized Interventions: A Reality in the Next 20 Years or Pie in the Sky. Pediatr Cardiol 2020; 41:486-502. [PMID: 32198592 DOI: 10.1007/s00246-020-02303-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/17/2020] [Indexed: 12/22/2022]
Abstract
There is no better representation of the need for personalization of care than the breadth and complexity of congenital heart disease. Advanced imaging modalities are now standard of care in the field, and the advancements being made to three-dimensional visualization technologies are growing as a means of pre-procedural preparation. Incorporating emerging modeling approaches, such as computational fluid dynamics, will push the limits of our ability to predict outcomes, and this information may be both obtained and utilized during a single procedure in the future. Artificial intelligence and customized devices may soon surface as realistic tools for the care of patients with congenital heart disease, as they are showing growing evidence of feasibility within other fields. This review illustrates the great strides that have been made and the persistent challenges that exist within the field of congenital interventional cardiology, a field which must continue to innovate and push the limits to achieve personalization of the interventions it provides.
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Acuna A, Berman AG, Damen FW, Meyers BA, Adelsperger AR, Bayer KC, Brindise MC, Bungart B, Kiel AM, Morrison RA, Muskat JC, Wasilczuk KM, Wen Y, Zhang J, Zito P, Goergen CJ. Computational Fluid Dynamics of Vascular Disease in Animal Models. J Biomech Eng 2019; 140:2676341. [PMID: 29570754 DOI: 10.1115/1.4039678] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Indexed: 12/19/2022]
Abstract
Recent applications of computational fluid dynamics (CFD) applied to the cardiovascular system have demonstrated its power in investigating the impact of hemodynamics on disease initiation, progression, and treatment outcomes. Flow metrics such as pressure distributions, wall shear stresses (WSS), and blood velocity profiles can be quantified to provide insight into observed pathologies, assist with surgical planning, or even predict disease progression. While numerous studies have performed simulations on clinical human patient data, it often lacks prediagnosis information and can be subject to large intersubject variability, limiting the generalizability of findings. Thus, animal models are often used to identify and manipulate specific factors contributing to vascular disease because they provide a more controlled environment. In this review, we explore the use of CFD in animal models in recent studies to investigate the initiating mechanisms, progression, and intervention effects of various vascular diseases. The first section provides a brief overview of the CFD theory and tools that are commonly used to study blood flow. The following sections are separated by anatomical region, with the abdominal, thoracic, and cerebral areas specifically highlighted. We discuss the associated benefits and obstacles to performing CFD modeling in each location. Finally, we highlight animal CFD studies focusing on common surgical treatments, including arteriovenous fistulas (AVF) and pulmonary artery grafts. The studies included in this review demonstrate the value of combining CFD with animal imaging and should encourage further research to optimize and expand upon these techniques for the study of vascular disease.
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Affiliation(s)
- Andrea Acuna
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Alycia G Berman
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Frederick W Damen
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Brett A Meyers
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Amelia R Adelsperger
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Kelsey C Bayer
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Melissa C Brindise
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Brittani Bungart
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Alexander M Kiel
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Rachel A Morrison
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Joseph C Muskat
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Kelsey M Wasilczuk
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Yi Wen
- Department of Agricultural and Biological Engineering, Purdue University, 225 South University Street, West Lafayette, IN 47907 e-mail:
| | - Jiacheng Zhang
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Patrick Zito
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Craig J Goergen
- ASME Membership Bioengineering Division, Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
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