TY - JOUR
T1 - A Fibrin-Thrombin Based In Vitro Perfusion System to Study Flow-Related Prosthetic Heart Valves Thrombosis
AU - Kreinin, Yevgeniy
AU - Talmon, Yahel
AU - Levi, Moran
AU - Khoury, Maria
AU - Or, Itay
AU - Raad, Mahli
AU - Bolotin, Gil
AU - Sznitman, Josué
AU - Korin, Netanel
N1 - © 2024. The Author(s).
PY - 2024/3/8
Y1 - 2024/3/8
N2 - Prosthetic heart valve (PHV) replacement has increased the survival rate and quality of life for heart valve-diseased patients. However, PHV thrombosis remains a critical problem associated with these procedures. To better understand the PHV flow-related thrombosis problem, appropriate experimental models need to be developed. In this study, we present an in vitro fibrin clot model that mimics clot accumulation in PHVs under relevant hydrodynamic conditions while allowing real-time imaging. We created 3D-printed mechanical aortic valve models that were inserted into a transparent glass aorta model and connected to a system that simulates human aortic flow pulse and pressures. Thrombin was gradually injected into a circulating fibrinogen solution to induce fibrin clot formation, and clot accumulation was quantified via image analysis. The results of valves positioned in a normal versus a tilted configuration showed that clot accumulation correlated with the local flow features and was mainly present in areas of low shear and high residence time, where recirculating flows are dominant, as supported by computational fluid dynamic simulations. Overall, our work suggests that the developed method may provide data on flow-related clot accumulation in PHVs and may contribute to exploring new approaches and valve designs to reduce valve thrombosis.
AB - Prosthetic heart valve (PHV) replacement has increased the survival rate and quality of life for heart valve-diseased patients. However, PHV thrombosis remains a critical problem associated with these procedures. To better understand the PHV flow-related thrombosis problem, appropriate experimental models need to be developed. In this study, we present an in vitro fibrin clot model that mimics clot accumulation in PHVs under relevant hydrodynamic conditions while allowing real-time imaging. We created 3D-printed mechanical aortic valve models that were inserted into a transparent glass aorta model and connected to a system that simulates human aortic flow pulse and pressures. Thrombin was gradually injected into a circulating fibrinogen solution to induce fibrin clot formation, and clot accumulation was quantified via image analysis. The results of valves positioned in a normal versus a tilted configuration showed that clot accumulation correlated with the local flow features and was mainly present in areas of low shear and high residence time, where recirculating flows are dominant, as supported by computational fluid dynamic simulations. Overall, our work suggests that the developed method may provide data on flow-related clot accumulation in PHVs and may contribute to exploring new approaches and valve designs to reduce valve thrombosis.
KW - Fibrin clot
KW - Hemodynamics
KW - Prosthetic heart valve
KW - Recirculating flow
KW - Thrombosis
KW - Models, Cardiovascular
KW - Perfusion
KW - Heart Valve Prosthesis
KW - Humans
KW - Thrombin
KW - Aortic Valve/surgery
KW - Fibrin/metabolism
UR - http://www.scopus.com/inward/record.url?scp=85186918364&partnerID=8YFLogxK
U2 - 10.1007/s10439-024-03480-6
DO - 10.1007/s10439-024-03480-6
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C2 - 38459196
AN - SCOPUS:85186918364
SN - 0090-6964
VL - 52
SP - 1665
EP - 1677
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 6
ER -