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Bioprosthetic Heart Valves–Replacing Order with Chaos: Electron Microscopic Study
Author(s) -
Datta Debatosh,
Kundu Prabuddha K.,
Bandyopadhyay Bhaskar N.
Publication year - 1999
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1999.06191.x
Subject(s) - cardiac valve , pericardium , heart valve , materials science , biomedical engineering , medicine , surgery
Rheumatic heart disease is a significant clinical entity in young children, especially in the developing world. One of the major long‐term effects of ill managed rheumatic fever is irreversible damage to the cardiac valve leaflets, primarily on the left side. With the limited success of currently available mechanical and bioprosthetic valves, there is an urgent need for new directions in bioprosthetic valves, both in material, including source, degree of fixation, surface, bulk modifications, etc., and design. In the present paper, new proposals in the material selection and fabrication of bioprosthetic valves are proposed based on electron microscopic studies of natural valve leaflets and the pericardial surface. Current approaches for bioprosthetic valve fabrications include the wide use of the pericardium as a leaflet material. The present study indicates a need for nondestructive surface examination of pericardial sheets for the elimination of areas of surface voids resulting from gross fiber disorientation. Also, there seems to be a need for incorporation of an in situ fiber renewal mechanism in bioprosthetic leaflets to emulate the natural valve more closely. Apparently natural leaflets have built‐in fiber renewal mechanism(s).