title: Biomechanical Behavior of Bioprosthetic Heart Valve Heterograft Tissues: Characterization, Simulation, and Performance.
abstract: The use of replacement heart valves continues to grow due to the increased prevalence of valvular heart disease resulting from an ageing population. Since bioprosthetic heart valves (BHVs) continue to be the preferred replacement valve, there continues to be a strong need to develop better and more reliable BHVs through and improved the general understanding of BHV failure mechanisms. The major technological hurdle for the lifespan of the BHV implant continues to be the durability of the constituent leaflet biomaterials, which if improved can lead to substantial clinical impact. In order to develop improved solutions for BHV biomaterials, it is critical to have a better understanding of the inherent biomechanical behaviors of the leaflet biomaterials, including chemical treatment technologies, the impact of repetitive mechanical loading, and the inherent failure modes. This review seeks to provide a comprehensive overview of these issues, with a focus on developing insight on the mechanisms of BHV function and failure. Additionally, this review provides a detailed summary of the computational biomechanical simulations that have been used to inform and develop a higher level of understanding of BHV tissues and their failure modes. Collectively, this information should serve as a tool not only to infer reliable and dependable prosthesis function, but also to instigate and facilitate the design of future bioprosthetic valves and clinically impact cardiology.
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA.
authors: Joao S
authors: JS
authors: Soares
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA.
authors: Kristen R
authors: KR
authors: Feaver
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA.
authors: Will
authors: W
authors: Zhang
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA.
authors: David
authors: D
authors: Kamensky
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA.|College of Engineering, Swansea University, Bay Campus, Fabian Way, Swansea, SA1 8EN, UK.
authors: Ankush
authors: A
authors: Aggarwal
authors: Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, Stop C0200, Austin, TX, 78712-1129, USA. msacks@ices.utexas.edu.
authors: Michael S
authors: MS
authors: Sacks
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena / Q000502:physiology*; D001705:Bioprosthesis; D003198:Computer Simulation; D006350:Heart Valve Prosthesis; D008955:Models, Cardiovascular; D011474:Prosthesis Design; D013552:Swine
keywords: Bioprosthetic heart valve; Constitutive modeling; Exogenous crosslinking; Fluid structure interaction; Heterograft; Mechanical testing; Modeling and simulation; Valve mechanics