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Bovine Pericardium of High Fibre Dispersion Has High Fatigue Life and Increased Collagen Content; Potentially an Untapped Source of Heart Valve Leaflet Tissue

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Abstract

Bioprosthetic heart valves (BHVs) are implanted in aortic valve stenosis patients to replace the native, dysfunctional valve. Yet, the long-term performance of the glutaraldehyde-fixed bovine pericardium (GLBP) leaflets is known to reduce device durability. The aim of this study was to investigate a type of commercial-grade GLBP which has been over-looked in the literature to date; that of high collagen fibre dispersion (HD). Under uniaxial cyclic loading conditions, it was observed that the fatigue behaviour of HD GLBP was substantially equivalent to GLBP in which the fibres are highly aligned along the loading direction. It was also found that HD GLBP had a statistically significant 9.5% higher collagen content when compared to GLBP with highly aligned collagen fibres. The variability in diseased BHV delivery sites results in unpredictable and complex loading patterns across leaflets in vivo. This study presents the possibility of a shift from the traditional choice of circumferentially aligned GLBP leaflets, to that of high fibre dispersion arrangements. Characterised by its high fatigue life and increased collagen content, in addition to multiple fibre orientations, GLBP of high fibre dispersion may provide better patient outcomes under the multi-directional loading to which BHV leaflets are subjected in vivo.

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Abbreviations

AS:

Aortic valve stenosis

BHV:

Bioprosthetic heart valve

GLBP:

Glutaraldehyde-fixed bovine pericardium

HA:

Highly aligned fibres

HD:

High fibre dispersion

PD:

Preferred fibre direction

SALS:

Small angle light scattering

SHG:

Second harmonic generation

TAVR:

Transcatheter aortic valve replacement

XD:

Cross fibre direction

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Acknowledgments

The authors would like to thank Brenton Cavanagh (Royal College of Surgeons, Ireland) for his assistance and expertise in conducting the SHG imaging in this study. This research is funded by the Irish Research Council and Boston Scientific Corporation (EBPPG/2016/353).

Author information

Authors and Affiliations

  1. Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland

    Alix Whelan, Elizabeth Williams, David R. Nolan, Bruce Murphy & Caitríona Lally

  2. Department of Mechanical, Manufacturing & Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland

    Alix Whelan, Elizabeth Williams, David R. Nolan, Bruce Murphy & Caitríona Lally

  3. Structural Heart Division, Boston Scientific Corporation, Galway, Ireland

    Alix Whelan & David O’Reilly

  4. Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland

    Bruce Murphy & Caitríona Lally

  5. Structural Heart Division, Boston Scientific Corporation, Los Gatos, CA, 95032, USA

    Paul S. Gunning

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  1. Alix Whelan
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  2. Elizabeth Williams
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Correspondence to Caitríona Lally.

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Appendix

Appendix

See Fig. 6 and Tables 3 and 4.

Figure 6
figure 6

SALS analysis overlaid on full GLBP patch. Interrogation region labelling (a–x) correspond to fibre architecture detailed in Table 4.

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Table 3 Specimen parameters and cycles completed for uniaxial cyclic loading detailed in “Uniaxial Cyclic Loading” section.
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Table 4 Mean collagen fibre angle and alignment values for interrogation regions on GLBP patch (n = 24).
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Whelan, A., Williams, E., Nolan, D.R. et al. Bovine Pericardium of High Fibre Dispersion Has High Fatigue Life and Increased Collagen Content; Potentially an Untapped Source of Heart Valve Leaflet Tissue. Ann Biomed Eng 49, 1022–1032 (2021). https://doi.org/10.1007/s10439-020-02644-4

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