Advantages

Artificial Heart Valves
  • Have significantly low regurgitation over the full range of physiological heart function
  • Eg: absolute functional envelope of cardiac output vs heart rate
  • Transvalvular pressure gradient is considerably small
  • Non or minimally thrombogenic
Different materials has different properties that need to be adapt into human environment. Click on the related subtopic to know more:
Polymer based scaffolds tissue-engineered heart valve
Natural tissue-engineered heart valve
Mechanical artificial heart valve

Polymer Based Scaffolds Tissue-Engineered Heart Valve

Consist a matrix which used to construct neotissue, which:
  • Enable three-dimensional cell growth
  • Provide a mode of cell delivery
  • Facilitate nutrient and waste transportation
  • Provide the necessary biomechanical support

Trileaflet polymeric heart valve

Polymeric heart valve fabricated from polyurethane/polysiliconeurethane

Tissue-Engineered Heart Valve
Tissue-engineered heart valve used polyesters
  • Biocompatible
  • Biodegradable
  • Well characterized
  • Approved by Food and Drug Administration for human implantation

Molecular structure of polylactic acid (left) and polyglycolic acid (right)

Tissue-engineered heart valve used thermoplastic polyesters
  • Can be isolated from naturally occurring bacteria or synthesized in the laboratory
  • Biocompatible
  • Biomechanical profile more closely resembled the native heart valve
  • Improved function

Molecular structure of polyhydroxyalkanoate

Tissue-engineered heart valve used polyhydroxyoctanoate
  • Possess higher stiffness

Tissue-engineered heart valve used poly-4-hydroxybutyrate
  • Inflow surface of leaflets:
  • Loose, spongy layer containing elastin and glycosoaminoglycans
  • Outflow surface of leaflets:
  • More fibrous layer containing collagen

Molecular structure of poly-4-hydroxybutyrate 

Natural Tissue-Engineered Heart Valve

  • More biocompatible and less immunogenic
  • Suitable for women who desire pregnancy and in patients older than 70 years
  • A low risk of thromboembolism
  • Only a small amount of blood thinner is needed to be taken by the patient to avoid clotting of the blood
  • Blood-thinning drugs are needed only for the first few months after surgery
  • The patient does not required to use Coumadin after surgery
  • The bileaflet valves have greater effective opening area
  • The valves do not click


Tissue-engineered heart valve generated from human marrow stromal cells

A typical porcine heart valve


  • Tissue-engineered heart valve using xeno- or allograft matrices (composed of valves devoid of cells with preservation of the extracellular matrix):
  • Help to maintain the valve's structural components
  • Biomechanical profile is maintained
  • A readily available and abundant scaffold material is obtained
  • Tissue-engineered heart valve using autologous cells:
  • Prevent immunological reaction that could cause rejection
  • Practicable due to endothelial cells and myofibroblasts enthusiastically developed in culture
  • Potential to bank autologous pluripotent cells which is significant in bringing tissue-engineered heart valves to clinical fruition

Mechanical Artificial Heart Valve

  • Very durable because they are made of strong materials like carbon, titanium, Teflon, polyester and Dacron
  • Can last 30 years or more after implant
  • Patient threat for future valve replacement re-operation is decreased
  • Suitable for children, young adults, and patients who have a high risk at re-operation
  • Good hemodynamic performance
  • New design features projected lower thromboembolic rates without loss of durability
  • No or less structural valve failure disc in terms of structural integrity


Mechanical heart valve Starr-Edwards model 1260

Model 6120 cardiac valvular prostheses

Medtronic-Hall aortic (left) and mitral (right) cardiac valvular prostheses

St. Jude Medical cardiac valvular prosthesis


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