Ostrich pericardium, a biomaterial for the construction of valve leaflets for cardiac bioprostheses: mechanical behaviour, selection and interaction with suture materials

Páez, J. M. García; Jorge-Herrero, Eduardo; Carrera, A.; Millán, Isabel; Rocha, A.; Calero, Patricia; Cordón, A.; Sainz, Natividad; Castillo‐Olivares, J. L.

doi:10.1016/s0142-9612(01)00014-x

Cited by 25 publications

(31 citation statements)

References 26 publications

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“…The objective of this report is to study the behavior of the calf pericardium employed in the manufacture of cardiac valve leaflets and that of a new biomaterial, ostrich pericardium, 18 when subjected to a tear test, and to assess the effects of the type of suture material and technique on the test results.…”

Section: Discussionmentioning

confidence: 99%

“…The initial results with respect to its resistance to rupture and its mechanical behavior were encouraging. 18 The purpose of this study was to assess the mechanical behavior of both calf and ostrich pericardium subjected to tear testing and the effect on the test results of the suture model and material employed. Thus, both biomaterials underwent in vitro tear testing in the two principal directions: longitudinal, or root to apex, and transverse, or circumferential.…”

Section: Introductionmentioning

confidence: 99%

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Resistance to tearing of calf and ostrich pericardium: Influence of the type of suture material and the direction of the suture line

Páez¹,

Carrera²,

Jorge³

et al. 2004

J Biomed Mater Res

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The tearing of the valve leaflet of a cardiac bioprosthesis can cause early failure of this device, which is employed to replace a diseased native valve. This report involves the study of the behavior of 312 tissue samples (152 of calf pericardium and 160 of ostrich pericardium) treated with glutaraldehyde and subsequently subjected to tear testing. The samples were cut in the two principal directions: longitudinally, or root to apex, and transversely. They included a series of control samples that were left unsutured, and the remaining samples were repaired with the use of two different suture techniques: a running suture in the direction of the load and a telescoping suture perpendicular to the load. Four commercially available suture materials were employed: Pronova, nylon, Gore-Tex, or silk. The unsutured control samples of both types of pericardium exhibited a similar anisotropic behavior in the tear test. The mean resistance to tearing of the calf pericardium was 24.29 kN m in samples cut longitudinally and 34.78 kN m in those cut transversely (p =.03); the values were 28.08 kN m and 37.12 kN m (p =.002), respectively, in ostrich pericardium. The series repaired with the telescoping suture always exhibited greater resistance to tearing, with values that ranged between 44.34 and 64.27 kN for the samples of calf pericardium and from 41.65 to 47.65 kN for those obtained from ostrich. These assays confirm the anisotropic behavior of calf and ostrich pericardium treated with glutaraldehyde when subjected to tear testing, as well as the loss of this behavior in ostrich pericardium after suturing. Suturing techniques, such as the telescoping model, that provide a greater resistance to tearing should be studied for use in the design of the valve leaflets of cardiac bioprostheses made of biological materials.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Resistance to tearing of calf and ostrich pericardium: Influence of the type of suture material and the direction of the suture line

Páez¹,

Carrera²,

Jorge³

et al. 2004

J Biomed Mater Res

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“…However, initial experimental studies demonstrated its high degree of resistance to rupture, tolerance to the suture, and acceptable homogeneity in terms of sample procurement and results. 1,2 On the other hand, current experience in the use of adhesives in medicine, and specifically in the field of cardiovascular surgery, is very limited. Their utilization in inert tissues, such as bioprostheses or implants, raises fundamental questions with regard to their mechanical resistance and stability over time.…”

Section: Introductionmentioning

confidence: 99%

Mechanical resistance of a new biomaterial, ostrich pericardium, and a new method of joining tissues combining suturing and a biological adhesive

et al. 2004

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We studied the mechanical behavior in response to tensile stress of samples of ostrich pericardium bonded with a cyanoacrylate glue or sewn with a rectangular, overlapping suture that was subsequently sealed with the same bioadhesive. Seventy-two trials were performed in three series of 24 samples each: series AG, glued with an overlap of 1 cm 2 ; series ASG, sewn with a rectangular, overlapping suture and sealed; and series AC, control samples that were left intact. The mean stress at rupture in series AG (glued) was 0.1 MPa, much lower than the working stress of a human valve leaflet, which is approximately 0.25 MPa. In the control series, this stress was 26.28 MPa. At rupture in series ASG (sutured/glued), the suture material was being subjected to a stress of 64.91 MPa, thus confirming the existence of an interaction between the suture and the shear stress exerted by the suture on the samples of pericardium. In series ASG, the mean value for the resistance to rupture when measured in machine kg was 8.83 kg, lower than but similar to that recorded in the control series AC (10.26 kg). The percentages of reversible deformation, or elongation, once the samples were torn were similar in series AC (19.15%) and ASG (21.93%). This phenomenon can only be explained by the damage to the collagen fibers in the area around the rupture, while other more distant regions work at a lower load within the elastic limit. We conclude that cyanocrylate adhesives alone are not suitable as bonding materials in cardiac bioprostheses. The results with the rectangular, overlapping suture, when subsequently sealed with an adhesive, can be considered good because, although this approach does not impede shear stress, it does maintain an excellent degree of resistance to rupture of the samples thus joined. We stress the need to take into account the concentration of the load in the design of bioprostheses.

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“…La homogeneidad en espesor es un criterio ampliamente empleado en la selección de materiales biológicos para su uso en prótesis valvulares [67].…”

Section: Hinchamientounclassified

“…Dentro de un mismo saco pericárdico se seleccionaron zonas de espesor homogéneo que, como se ha explicado anteriormente, es uno de los principales criterios de calidad normalmente utilizados [67]. Este criterio consiste en la exclusión de las probetas cuya diferencia absoluta entre su espesor medio y mínimo, supere el valor de la desviación estándar de la serie a la que pertenece la probeta.…”

Section: Selección Del Materialsunclassified

Caracterización mecánica de materiales de base colágeno para aplicaciones cardiovasculares

Arnedo¹,

Almudena²

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Ostrich pericardium, a biomaterial for the construction of valve leaflets for cardiac bioprostheses: mechanical behaviour, selection and interaction with suture materials

Cited by 25 publications

References 26 publications

Resistance to tearing of calf and ostrich pericardium: Influence of the type of suture material and the direction of the suture line

Resistance to tearing of calf and ostrich pericardium: Influence of the type of suture material and the direction of the suture line

Mechanical resistance of a new biomaterial, ostrich pericardium, and a new method of joining tissues combining suturing and a biological adhesive

Caracterización mecánica de materiales de base colágeno para aplicaciones cardiovasculares

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