Computational modeling of externally mounted pericardial heart valves highlights the need to balance structural and functional requirements when tuning tissue properties and stent stiffness.
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May guide pericardial valve design to reduce focal stress; leaves open optimal anisotropy-stent stiffness balance pending in vivo validation.
Our aim was to understand the structural and functional behaviour of a pericardial heart valve with biological leaflets attached externally to a stent. To our knowledge, there is little if any literature concerning these kinds of bioprosthetic heart valves, while there is more concerning bioprosthetic heart valves with leaflets mounted internally. We studied the problem using a finite element approach considering leaflets and stent interaction, the influence of leaflet anisotropy and stent stiffness, by comparing quasi-static and dynamic loadings. Although we considered the problem to be symmetric and fluid-structure interaction was not implemented, we believe that our results could be a solid basis for valve optimization. We found regions of high stress concentration at the commissure near the stent tip and at the base of the leaflet cusp. The structural behaviour in the first region was complex, while the stress in the second region acted radially because of high bending. Although leaflet tissue anisotropy and stent stiffness exerted a significant influence on the structural and functional behaviours, they had a contrasting effect on leaflet stress state, coaptation and valve opening. Therefore, a good optimization should take into account both structural and functional requirements when tuning tissue properties and stent stiffness.
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Avanzini et al. (2014) studied this question.
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