Abstract
ObjectivesReplacement aortic valves endeavor to mimic native valve function at the organ, tissue, and in the case of bioprosthetic valves, the cellular levels. There is a wealth of information about valve macro and micro structure; however, there presently is limited information on the morphology of the whole valve fiber architecture. The objective of this study was to provide qualitative and quantitative analyses of whole valve and leaflet fiber bundle branching patterns using a novel imaging system.MethodsWe developed a custom automated microscope system with motor and imaging control. Whole leaflets (n = 25) were imaged at high resolution (e.g. 30,000×20,000 pixels) using elliptically polarized light to enhance contrast between structures without the need for staining or other methods. Key morphologies such as fiber bundle size and branching were measured for analyses.ResultsThe left coronary leaflet displayed large asymmetry in fiber bundle organization relative to the right coronary and non-coronary leaflets. We observed and analyzed three main patterns of fiber branching; tree-like, fan-like, and pinnate structures. High resolution images and quantitative metrics are presented such as fiber bundle sizes, positions, and branching morphological parameters.SignificanceTo our knowledge there are currently no high resolution images of whole fresh leaflets available in the literature. The images of fiber/membrane structures and analyses presented here could be highly valuable for improving the design and development of more advanced bioprosthetic and/or bio-mimetic synthetic valve replacements.
Highlights
Heart valves are specialized structures that prevent the backflow of blood into the chambers of the heart
Two-thirds of heart valve related hospital discharges and mortalities involve the aortic valve [1], the aortic valve is of particular interest
The overall goal of this study was to provide a quantitative evaluation of meso-scale fiber and membrane structure of the aortic valve cusp leaflets, which can contribute to the understanding of the structure-function relationships of the aortic valve
Summary
Heart valves are specialized structures that prevent the backflow of blood into the chambers of the heart This function can be undermined by diseases such as calcification or congenital defect. In 2009, over 139,000 medical procedures were performed in the US related to heart valves, of which 89,000 were in patients 65+ years old [1]. This presents a growing concern considering the rising elderly population. Two-thirds of heart valve related hospital discharges and mortalities involve the aortic valve [1], the aortic valve is of particular interest If conservative treatment such as valve repair cannot sufficiently restore a valve’s function, a replacement valve made of either synthetic or biological material will be installed. While the current prosthetic valves have undeniable medical value, there are drawbacks in terms of durability and biocompatibility which underscore the need for better understanding of valve ‘mesostructure’ (i.e. fiber bundle and membrane structures) to potentially enable a more modern tissue engineered repair/solution [2,3]
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