Skip to main content Accesibility Help
×
×
Home
  • Print publication year: 2011
  • Online publication date: June 2012

14 - Cardiovascular devices

from Part III - Case studies
Summary

Inquiry

How would you design a novel mechanical heart valve using only synthetic materials?

In the development of medical implants, designers and engineers frequently attempt to replicate both the geometry and function of the natural tissue requiring replacement. This is not true in the case of mechanical heart valves, which utilize designs that mimic the function of natural heart valves but not necessarily the geometry. Perhaps this is because the most important aspect of heart valve design – that is, to provide a long-term method for regulating fluid flow without damaging red blood cells – can be achieved in a number of ways. When considering the lifetime of the device, another challenge presents itself: the average adult heart rate is approximately 72 beats per minute and this translates to nearly 38 million fatigue cycles per year. What are other methods, beyond what is already on the market, to creatively design an implant that can withstand high-cycle fatigue while regulating blood flow without damaging red blood cells?

Historical perspective and overview

Cardiovascular disease can refer to any set of symptoms that affects the cardiovascular system (namely, the heart and blood vessels). Some people are born with cardiovascular disease and others develop it over a lifetime. In this textbook, the focus is on aspects of cardiovascular disease that can be handled through the use of a structural or load-bearing implant. This includes coronary heart disease (a lack of circulation to the heart and surrounding tissue), congestive heart failure (the inability of the heart to pump sufficient blood through the body), and valvular disease (heart valves experiencing regurgitation or incompetency). The electrical stimulation of the heart muscle through the use of a pacemaker will not be discussed, but the reader is encouraged to read the text by Al-ahmed and co-workers (2010) for more information on that topic. The most common type of cardiovascular disease is coronary artery disease, in which the arteries that supply oxygenated blood to the heart become partially blocked by the formation of plaque (the build-up of fibrous tissue, fatty lipids, and calcifications that occurs on the intimal side of vascular wall). This reduction of the arterial lumen, or opening, due to plaque accumulation is one of the characteristics of atherosclerosis (Ross, 1999).

Recommend this book

Email your librarian or administrator to recommend adding this book to your organisation's collection.

Mechanics of Biomaterials
  • Online ISBN: 9780511977923
  • Book DOI: https://doi.org/10.1017/CBO9780511977923
Please enter your name
Please enter a valid email address
Who would you like to send this to *
×
References
Allie, D.E.Hebert, C.J.Walker, C.M. 2004 22
Bass, J.L.Gruenstein, D.H. 2009 Cardiac septal defects: treatment via the Amplatzer family of devicesHandbook of Cardiac Anatomy, Physiology and DevicesIaizzo, P.A.New YorkSpringer571
Baura, G.D. 2006 Engineering Ethics: An Industrial PerspectiveBurlington, MAElsevier Academic Press
Bhat, S.V. 2005 BiomaterialsMiddlesex, UKAlpha Science
Blackstone, E.H. 2005 Could it happen again?: the Björk-Shiley Convexo-Concave Heart Valve storyCirculation 111 2717
Buvaneshwar, G.S.Ramani, A.V.Chandran, K.B. 2002 Polymeric occluders in tilting disk heart valve prosthesesPolymeric BiomaterialsDumitriu, S.New YorkMarcel Dekker589
Chandran, K.B.Burg, K.J.Shalaby, S.W. 2003 Soft tissue replacementsBiomaterials: Principles and ApplicationsPark, J.B.Bronzino, J.D.Boca Raton, FLCRC Press141
Dauskardt, R.H.Ritchie, R.O. 1999 Pyrolitic carbon coatingsAn Introduction to BioceramicsHench, L.L.Wilson, J.River Edge, NJWorld Scientific Publishing261
Didisheim, P.Watson, J.T. 1996 Cardiovascular applicationsBiomaterials Science: An Introduction to Materials in MedicineRatner, B.D.Hoffman, A.S.Schoen, F.J.Lemons, J.E.San Diego, CAElsevier Academic Press283
Duda, S.H.Pusich, B.Richter, G.Landwehr, P.Oliva, V.L.Tielbeek, A.Bérégi, J.P. 2002 Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month resultsCirculation 106 1505
Fischman, D.L.Leon, M.B.Baim, D.S.Schatz, R.A.Savage, M.P.Penn, I.Goldberg, S. 1994 A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery diseaseNew England Journal of Medicine 331 496
Fligner, C.L.Reichenbach, D.D.Otto, C.M. 2004 Pathology and etiology of valvular heart diseaseValvular Heart DiseaseOtto, C.M.Philadelphia, PAElsevier
Fong, P.F.Park, J.Breuer, C.K. 2007 Heart valvesPrinciples of Tissue EngineeringLanza, R.P.Langer, R.S.Vacanti, J.Burlington, MAElsevier Academic Press585
Food and Drug Administration 1999 www.fda.gov
Food and Drug Administration 2000 SubmissionsRockville, MDFDA
Food and Drug Administration 2001 www.fda.gov
Food and Drug Administration 2010 Rockville, MDFDA
Food and Drug Administration 2010 Rockville, MDFDA
Guidant Corporation 1999 www.fda.gov
Ku, D.N.Allen, R.C. 2000 Vascular graftsThe Biomedical Engineering HandbookBronzino, J.D.Boca Raton, FLCRC Press128
Lloyd-Jones, D.Adams, R.J.Brown, T.M.Carnethon, M.Dai, S.De Simone, G.Wylie-Rosett, J. 2010 Heart disease and stroke statistics 2010 update: A report from the American Heart AssociationCirculation 121 e46
Meier, B. 2007 Percutaneous coronary interventionTextbook of Cardiovascular MedicineCaliff, R.M.Prystowsky, E.N.Thomas, J.D.Thompson, P.D.Philadelphia, PALippincott, Williams & Wilkins1258
Okamoto, R.J. 2008 Blood vessel mechanicsEncyclopedia of Biomaterials and Biomedical EngineeringWnek, G.E.Bowlin, G.L.New YorkInforma Healthcare392
Padera, Jr., R.F.Schoen, F.J. 2004 Cardiovascular medical devicesBiomaterials Science: An Introduction to Materials in MedicineRatner, B.D.Hoffman, A.S.Schoen, F.J.Lemons, J.E.San Diego, CAElsevier Academic Press470
Palacios, I.F. 2006 Closure of interatrial communications using the CardioSEAL and STARFlex devicesPercutaneous Device Closure of the Atrial SeptumBrecker, S.J.D.LondonInforma UK121
Pelton, A.R.Schroeder, V.Mitchell, M.R.Gong, X.-Y.Barney, M.Robertson, S.W. 2008 Fatigue and durability of nitinol stentsJournal of the Mechanical Behavior of Biomedical Materials I 1 153
Piehler, H.R.Hughes, A.A. 2004 The role of post-market surveillance in the medical device risk management systemEngineering Systems SymposiumCambridge, MA29
Ross, R. 1999 Atherosclerosis – an inflammatory diseaseNew England Journal of Medicine 340 115
Scheinert, D.Scheinert, S.Sax, J.Piorkowski, C.Braunlich, S.Ulrich, M.Schmidt, A. 2005 Prevalence and clinical impact of stent fractures after femoropopliteal stentingJournal of the American College of Cardiology 45 312
Schoen, F.J. 2005 Cardiac valves and valvular pathology: update on function, disease, repair and replacementCardiovascular Pathology 14 189
Sigg, D.C.Hezi-Yamit, A. 2009 Cardiac and vascular receptors and signal transductionHandbook of Cardiac Anatomy, Physiology and DevicesIaizzo, P.A.New YorkSpringer191
Sigwart, U.Puel, J.Velimir, M.Joffre, F.Kappenberg, L. 1997 Intravascular stents to prevent occlusion and restenosis after transluminal angioplastyNew England Journal of Medicine 316 701
Silver, F.H. 1994 Cardiovascular implantsBiomaterials, Medical Devices, and Tissue Engineering: An Integrated ApproachLondon, UKChapman and Hall153
United States Attorney's Office, Northern District of California 2003 www.justice.gov
Ventre, M.Netti, P.Urciuolo, F.Ambrosio, L. 2009 Soft tissues characteristics and strategies for their replacement and regenerationStrategies in Regenerative Medicine: Integrating Biology with Materials DesignSantin, M.New YorkSpringer
White, C.J.Ramee, S.R. 2003 Aortoiliac artery angioplasty and stentingPeripheral Vascular Stenting for CardiologistsHeuser, R.LondonMartin Dunitz Ltd39
Yoganathan, A.P. 2000 Cardiac valve prosthesesThe Biomedical Engineering HandbookBronzino, J.D.Boca Raton, FLCRC Press127
Bibliography
2009 Central Venous CathetersHamilton, H.Bodenham, A.Chichester, UKJohn Wiley & Sons, Ltd
2010 Pacemakers and Implantable Cardioverter Defibrillators: An Expert's ManualAl-ahmad, A.Ellenbogen, K.A.Natale, A.Wang, P.J.Minneapolis, MNCardioText Publishing
Blitz, A.Fang, J.C. 2010 Ventricular assist devices and total artificial heartsDevice Therapy in Heart FailureMaisel, W.H.New YorkHumana Press339
Bolooki, H. 1998 Clinical Application of the Intra Aortic Balloon PumpArmonk, NYFutura Publishing
Netter, F.H. 2011 Atlas of Human AnatomyPhiladelphia, PASaunders Elsevier