Development And Characterization Of An Anisotropic Biomimetic Polymeric Patch To Improve The Durability Of Surgical Heart Valve Repair
David Kalfa, Mingze Sun, Caroline Giuglaris, Giovanni Ferrari, Emile Bacha.
Columbia University College of Physicians and Surgeons, New York, NY, USA.
Objective: Patches currently used for heart valve repair are not durable. We hypothesize that a polymeric “biomimetic” patch that replicates the three-layer architecture and anisotropic mechanical properties of a native leaflet will display a better durability. Our objective is to fabricate, test mechanically and biologically and compare this patch to commercial patches and native leaflets.
Methods: A polycarbonate polyurethane (PCU)-based patch, with aligned polycaprolactone (PCL) fibers (Fig 1A), was fabricated via solution casting, electrospinning and lyophilization methods. In vitro and in vivo mechanical and biological tests were performed to compare the biomimetic patch to commercial ones (GoreTex, Cardiocel, CorMatrix) and native leaflets.
Results: The biomimetic patch has a Film-Foam-Film structure that mimics the three-layered architecture of native leaflet (Fig 1B). Compared to three commercial patches, our customized, biomimetic composite patch (composite) exhibited an anisotropic behavior and mechanical properties close to human valve leaflets (HVL) in horizontal(H)/circumferential(CIRC) direction, and vertical(V)/radial(RAD) direction (Fig 1C). The mechanical properties were more stable over time compared to commercial patches (Fig 1D). In vitro and in vivo biocompatibility tests showed a lower protein adsorption, lower calcium adhesion level, and less calcification compared to commercial non-polymeric patches (Fig 1E, 1F& 1G).
Conclusions: The PCU/PCL-based biomimetic patch replicates the native leaflet’s architecture and display mechanical properties that are close to aortic leaflets, as well as an excellent biostability and biocompatibility.
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