New insights and novel perspectives in bileaflet mechanical heart valve prostheses thromboresistance.

Mechanical heart valve Nano-technology Superhydrophobic Thromboresistance Warfarin-free

Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
17 May 2024
Historique:
received: 06 10 2023
accepted: 30 04 2024
medline: 18 5 2024
pubmed: 18 5 2024
entrez: 17 5 2024
Statut: epublish

Résumé

Although well-known for their thromboresistance, bileaflet mechanical heart valves (BMHV) require lifelong anti-thrombotic therapy. This must be associated with a certain level of thrombogenicity. Since both thromboresistance and thrombogenicity are explained by the blood-artificial surface or liquid-solid interactions, the aim of the present study was to explore BMHV thromboresistance from new perspectives. The wettability of BMHV pyrolytic carbon (PyC) occluders was investigated in under-liquid conditions. The submerged BMHV wettability clarifies the mechanisms involved in the thromboresistance. The PyC occluders of a SJM Regent™ BMHV were previously laser irradiated, to create a surface hierarchical nano-texture, featuring three nano-configurations. Additionally, four PyC occluders of standard BMHV (Carbomedics, SJM Regent All the standard occluders showed very low contact angle, reflecting a pronounced affinity for non-polar molecules. No receding of the contact line could be observed for the untreated occluders. The smallest static contact angle of around 61° could be observed for On-X BMHV "fear" water and blood. The intrinsic affinity of BMHV for nonpolar fluids can be translated into a tendency to repel polar fluids, such as water and blood. The blood-artificial surface interaction in BMHV is minimized. The contact between blood and BMHV surface is drastically reduced by polar-nonpolar Van der Waals forces. The "hydro/bloodphobia" of BMHV is intrinsically related to their chemical composition and their surface energy, thus their material: PyC indeed. Pertaining to thromboresistance, the surface roughness does not play a significant role. Instead, the thromboresistance of BMHV lies in molecular interactions. BMHV wettability can be tuned by altering the surface interface, by means of nanotechnology.

Sections du résumé

BACKGROUND BACKGROUND
Although well-known for their thromboresistance, bileaflet mechanical heart valves (BMHV) require lifelong anti-thrombotic therapy. This must be associated with a certain level of thrombogenicity. Since both thromboresistance and thrombogenicity are explained by the blood-artificial surface or liquid-solid interactions, the aim of the present study was to explore BMHV thromboresistance from new perspectives. The wettability of BMHV pyrolytic carbon (PyC) occluders was investigated in under-liquid conditions. The submerged BMHV wettability clarifies the mechanisms involved in the thromboresistance.
METHODS METHODS
The PyC occluders of a SJM Regent™ BMHV were previously laser irradiated, to create a surface hierarchical nano-texture, featuring three nano-configurations. Additionally, four PyC occluders of standard BMHV (Carbomedics, SJM Regent
RESULTS RESULTS
All the standard occluders showed very low contact angle, reflecting a pronounced affinity for non-polar molecules. No receding of the contact line could be observed for the untreated occluders. The smallest static contact angle of around 61° could be observed for On-X
CONCLUSIONS CONCLUSIONS
BMHV "fear" water and blood. The intrinsic affinity of BMHV for nonpolar fluids can be translated into a tendency to repel polar fluids, such as water and blood. The blood-artificial surface interaction in BMHV is minimized. The contact between blood and BMHV surface is drastically reduced by polar-nonpolar Van der Waals forces. The "hydro/bloodphobia" of BMHV is intrinsically related to their chemical composition and their surface energy, thus their material: PyC indeed. Pertaining to thromboresistance, the surface roughness does not play a significant role. Instead, the thromboresistance of BMHV lies in molecular interactions. BMHV wettability can be tuned by altering the surface interface, by means of nanotechnology.

Identifiants

pubmed: 38760659
doi: 10.1186/s13019-024-02786-9
pii: 10.1186/s13019-024-02786-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

292

Informations de copyright

© 2024. The Author(s).

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Auteurs

Giorgio Vigano (G)

Department of Cardiothoracic Surgery, Heart Centre, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, Groningen, 9700 RB, The Netherlands. g.vigano@umcg.nl.

Sudip Shyam (S)

Micro & Nano-Scale Transport Laboratory, Waterloo Institute for Nanotechnology, Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Waterloo, ON, N2L 3G1, Canada.

Sushanta K Mitra (SK)

Micro & Nano-Scale Transport Laboratory, Waterloo Institute for Nanotechnology, Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Waterloo, ON, N2L 3G1, Canada.

Daniël K M Pollack (DKM)

Department of Cardiothoracic Surgery, Heart Centre, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, Groningen, 9700 RB, The Netherlands.

Massimo A Mariani (MA)

Department of Cardiothoracic Surgery, Heart Centre, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, Groningen, 9700 RB, The Netherlands.

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