Aortic heart valve diseases, such as calcification, are typically treated by replacement with a bioprosthetic heart valve that restores valve function.

Recently, percutaneous bioprosthetic heart valve replacement, a minimally invasive treatment that involves catheter-based deployment, has become popular. Such designs require thin, flexible biological tissues that can fit into delivery catheters, but the impact of using such tissues is unclear.

The authors used high-fidelity computational methods to model and simulate four bioprosthetic aortic heart valve implants and evaluated the impact of using thin tissues on bioprosthetic heart valve function.

The authors found that thin tissues induced significant leaflet flutter, a phenomenon that generated irregular, oscillatory valve behavior and may accelerate leaflet deterioration and reduce valve durability.

The flutter motion also induced disturbed blood flow patterns that can lead to an increased risk of blood damage and thrombosis.

According to the authors, thinner, more flexible tissues can have a potentially serious impact on bioprosthetic heart valve function due to the adverse effects of leaflet flutter on valve structural integrity and on blood flow throughout the cardiac cycle.

https://www.pnas.org/content/early/2020/07/23/2002821117