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ملخص

Abstract

Heart valve bioprostheses suffer from gradual tissue deterioration, which has a causal link with valve tissue mechanical properties. Limited data on mechanical properties of commercially available bioprostheses comparing them to native human aortic valves (AV) is available. Our objective was to determine the mechanical properties of several contemporary bioprostheses and compare them with native human and porcine aortic valves. Leaflets from 5 unchanged human AV, collected from cadaveric hearts and 5 porcine AV, and from 3 of each kind of bioprostheses - Medtronic Hancock II, Sorin Soprano and Medtronic Freestyle were analysed using uniaxial tensile tests in radial and circumferential directions. Data are presented as means ± standard deviation. In both tested directions there's a shift to the stress axis of stress-strain curve for HancockII prostheses and even more for Soprano prostheses when compared to native human valves. In circumferential direction modulus of elasticity (E) of native human AV is 15.34±3.84MPa, porcine AV - 9.7±1.3MPa, Freestyle - 9.0±3.0MPa, HancockII - 22.5±2.2MPa and Soprano - 29.5±6.0MPa. In radial direction E of native human AV is 1.98±0.15MPa, porcine AV - 1.0±0.2MPa, Freestyle - 0.8±0.3MPa, HancockII - 2.5±0.2MPa and Soprano - 15.8±5.4MPa. Xeno-aortic bioprostheses have a non-linear and anisotropic response to stress in uniaxial tensile tests similar to native AV leaflets. HancockII has gained mechanical strength but lost tissue elasticity compared to native valve tissue. Leaflets of Soprano prostheses are even more rigid and lack pronounced material anisotropy. These differences in mechanical properties may accelerate deterioration of bioprostheses, causing altered stress distribution within valve leaflets. These data provide important information about what mechanical properties future valve substitutes should conform to.

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