Prosthetic Heart Valves Are Critical Component of the Treatment of Patients with Vulvular Heart Disease

 

Prosthetic Heart Valves

Prosthetic Heart Valves (SHVs) are designed to replace the damaged valves of the human heart. They are a critical component of the treatment of patients with valvular heart disease. A variety of mechanical and bioprosthetic heart valves are available for aortic and mitral valve replacement. They have been developed to improve hemodynamics, avoid anticoagulation requirements, and minimize biological response to the prosthesis.

Mechanical valves are composed of a strutted or disc-like structure with an occluder in the center and an opening orifice at either end. Prosthetic Heart Valves shape and the degree of strut movement can determine the flow resistance, the area of turbulent shear stress, and the overall efficacy of the prosthesis. These designs have also been developed to minimize acoustic shadowing.

Tissue-derived heart valves are made from animal or non-animal tissue sources. They can be either valvular or non-valvular, and are typically fixed in glutaraldehyde to reduce the risk of immunogenicity. In this process, the antigens are removed and cross-linked so that they are not recognized by the body. However, the resulting prostheses have been reported to suffer from structural valve degeneration. Hence, they are often subject to reintervention for symptomatic dysfunction.

The surgical bioprosthetic valve is an increasingly popular alternative to aortic and mitral prostheses. Prosthetic Heart Valves offer the advantage of avoiding anticoagulation, however, require ongoing monitoring of internationalized normalized ratios to ensure patient compliance. Consequently, they are associated with the risk of bleeding and thromboembolism.

Several studies have been conducted to evaluate the performance of bioprosthetic leaflets in different physiological conditions. The main objective is to understand the stress and strain distribution of the leaflets during a cardiac cycle. Some of these studies use a linear elastic orthotropic material model, while others rely on a shell model. Among the latter, Fung’s constitutive model has been widely used to simulate the stress response of bioprosthetic valve leaflets. In March 2022, the U.S. Food and Drug Administration (FDA) granted approval to Edwards Lifesciences for the MITRIS RESILIA valve.

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