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Biomedical subjects

Richard T Schoephoerster

Publications and source records attributed to Richard T Schoephoerster.

5 recordsLinked to original sources

Effect of fiber orientation on the stress distribution within a leaflet of a polymer composite heart valve in the closed position.

Polymer trileaflet valves offer natural hemodynamics with the potential for better durability than commercially available tissue valves. Strength and durability of polymer-based valves may be increased through fiber reinforcement. A finite element analysis of the mechanics of a statically loaded polymer trileaflet aortic heart valve has been conducted. A parametric analysis was performed to determine the effects of fiber orientation and volume density in a single and double ply model. A maximum stress value of 1.02MPa was obtained in the non-reinforced model for a transvalvular load (downstream-upstream) of 120mmHg. The maximum stress on the downstream side of the leaflet was approximately twice the maximum stress on the upstream side, and always occurred on the interface with the valve stent. The single ply model reduced the stress on the polymer matrix, with the maximum reduction of at least 64% occurring when the fiber orientation was such that the fibers ran perpendicular to the stent edge. The double ply model further reduced the stress on the polymer matrix, with the maximum reduction of greater than 86% now occurring when the fibers are oriented most perpendicular to one another.

Biomechanical Phenomena↗

A novel polymer for potential use in a trileaflet heart valve.

A novel polyolefin, poly(styrene-b-isobutylene-b-styrene) (Quatromer), is being proposed as a viable polymer for use in trileaflet heart valves because of its oxidative stability. The current study was designed to assess the polymer's hemocompatibility and mechanical durability. Mechanical characterization included static tensile tests and dynamic tension-tension and bending fatigue tests, where the properties of isotropic and composite (polypropylene (PP) embedded) Quatromer specimens were compared with those of a polyurethane (PUR) approved for cardiovascular applications. It was found that by embedding PP fibers into the Quatromer matrix, the tensile and fatigue properties of the polymer could be improved, making them comparable, if not better than the PUR. The thrombotic potential of Quatromer was compared with the PUR, glutaraldehyde-fixed porcine valve material, and a positive and negative control by measuring platelet deposition with radiolabeled platelets in a parallel plate flow configuration. The porcine valve material was found to have significantly higher platelet deposition under all flow regimes, while no significant difference existed between Quatromer and PUR. In conclusion, Quatromer is shown to have suitable hemocompatibility and mechanical durability for use in polymer trileaflet heart valves, and fiber reinforcement can effectively be used to tailor the mechanical properties.

Animals↗

Spatial distribution of platelet deposition in stented arterial models under physiologic flow.

This paper presents dynamic flow experiments with fluorescently labeled platelets to allow for spatial observation of wall attachment in inter-strut spacings, to investigate their relationship to flow patterns. Human blood with fluorescently labeled platelets was circulated through an in vitro system that produced physiologic pulsatile flow in a parallel plate flow chamber that contained three different stent designs that feature completely recirculating flow, partially recirculating flow (intermediate strut spacing), and completely reattached flow. Highly resolved spatial distribution of platelets was obtained by imaging fluorescently labeled platelets between the struts. Platelet deposition was higher in areas where flow is directed towards the wall, and lower in areas where flow is directed away from the wall. Flow detachment and reattachment points exhibited very low platelet deposition. Platelet deposition within intermediate strut spacing continued to increase throughout the experimental period, indicating that the deposition rate had not plateaued unlike other strut spacings. The spatial uniformity and temporal increase in platelet deposition for the intermediate strut spacing confirms and helps explain our previous finding that platelet deposition was highest with this strut spacing. Further experimental investigations will include more complex three-dimensional geometries.

Arteries↗

Flow-induced platelet activation in a St. Jude mechanical heart valve, a trileaflet polymeric heart valve, and a St. Jude tissue valve.

Polymer heart valves have been under investigation since the 1960s, but their success has been hampered by an overall lack of durability mainly due to calcification of the leaflets and a relatively high rate of thromboembolic complications. A new polymer (Quatromer) trileaflet design was tested for its thrombogenic potential and was compared to that of existing prosthetic heart valves routinely implanted in patients: a St. Jude Medical bileaflet mechanical heart valve (MHV) and a St. Jude porcine bioprosthetic tissue valve. The valves were mounted in a left ventricular assist device and the procoagulant activity of the platelets was measured using a platelet activation state (PAS) assay. The PAS measurements indicated that the platelet activation level induced by the polymeric valve was very similar to that induced by the St. Jude Medical MHV and the St. Jude tissue valve. No significant difference was observed between the three valves, indicating that they have a comparable thrombogenic potential.

Bioprosthesis↗

Platelet adhesion to simulated stented surfaces.

PURPOSE: To determine if the protrusion of stent struts into the flow stream, which creates stagnation along the wall dependent on the strut spacing, has an effect on platelet adhesion. METHODS: Three 2-dimensional stents with different strut spacings were placed in a flat-plate flow chamber. Human blood was collected and platelets were labeled with indium 111. The blood with radioactive platelets was pumped through the flow chamber for 30 minutes to produce a pulsatile wall shear stress of 10+/-5 dynes/cm2 (mean +/- amplitude at 1 Hz). A gamma counter measured radioactivity along the surface and on the stents. Computational flow simulations provided specific data on flow separation and wall shear stress for each stent strut spacing tested (2.5, 4.0, and 7.0 times the strut height). RESULTS: The presence of any stent provoked an elevation in platelet adhesion within the stented region (p<0.05). The stents with larger strut spacing had higher platelet adhesion on the substrate in the stented region (1.71+/-0.63 normalized platelet deposition for the 7.0 model and 2.11+/-1.02 for the 4.0 model) than stents with smaller strut spacing (1.37+/-0.68 for the 2.5 model, p<0.05). The stents themselves showed platelet adhesion levels that were 3 to 7 times higher than the substrates, with a similar dependence on stent strut spacing. CONCLUSIONS: Additional knowledge of the role of mechanical factors in stent restenosis will aid in designing stents that minimize intimal hyperplasia and restenosis. The results of this study demonstrate the importance of stent design-mediated blood flow patterns, with smaller strut spacings minimizing platelet adhesion per unit strut area.

Blood Platelets↗