Abstract
Introduction. Calcification of biological prosthetic heart valves is one of the main unsolved problems in cardiac surgery. The polarity of biological tissue, i.e. the ability to undergo calcinosis and fibrosis differently in the recipient's body depending on the side implanted in the bloodstream, has been practically proven. The aim of this work is to study the hemodynamic characteristics of the proposed unipolar bioprosthesis model using a pulse duplicator.
Material and methods. As a material for the manufacture of a biological prosthesis, a glisson capsule of cattle was used, stabilized by a standard method with glutaraldehyde. For testing, a pulse duplicator ("MedInzh") was used, which allows simulating the pulsating flow and conditions of the valve functioning in the aortic, mitral and tricuspid positions in the human body.
Results. The new tricuspid conduit, made entirely from the Glisson capsule of the bovine liver, is a single tubular structure with a locking element. Unlike previous grafts, the valve apparatus of this prosthesis is not an additional "applied" element that formed a folded roughness at the junction of the frame to the sashes. Of course, this rudeness did not create conditions for unhindered hemodynamics in the excretory part of the right ventricle. It is the new design of the presented prosthesis and the material (Glisson liver capsule) that is its main characteristic, which in our opinion is the main advantage of the new conduit. The design of the conduit proposed by us is such that only the diaphragmatic surface of the glisson capsule of the liver contacts the systemic blood flow, which has a native mesothelial lining and a basal membrane, which contributes to the lesser development of calcification and fibrosis processes after implantation. For testing on a pulse duplicator, we proposed a frameless tricuspid prosthesis that was installed in a cylindrical plexiglass mandrel of the appropriate size. Parameters of the pulse duplicator operation (parameters of test modes) were set taking into account the position of the implantable bioprosthesis (pulmonary).
Conclusion. The test results showed high hemodynamic characteristics of the proposed bioprosthesis, both in comparison with mechanical prosthetics of heart valves, and in comparison with existing bioprostheses.
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About the authors
- Dmitriy V. Britikov, Dr. Med. Sc., Head of the Group for Experimental Development of Biological Materials for Cardiovascular Surgery, orcid.org/0000-0002-6942-6611
- Khushnud Sh. Nizamov, Postgraduate, orcid.org/0000-0002-7656-3278
- Andrey V. Agafonov, Cand. Tech. Sc., Senior Researcher, orcid.org/0000-0002-0261-3527
