Geometric optimization of a tissue pattern for semilunar valve reconstruction

Background and aim of the study: A novel geometric trefoil pattern has been suggested for semilunar valve reconstruction. Optimization of the geometry must rely on an appreciation of normal anatomy and knowledge of the mechanical properties of the tissue used for the reconstruction. Methods: Computer-assisted design (CAD) was used to create an optimized leaflet geometry based on published dimensions for normal human aortic valves. The optimized leaflet geometry was subjected to finite element analysis (FEA) to study stress distribution with pressure loading of the leaflet. In vitro function of the optimized trefoil tissue pattern is being studied by static testing initially, with physiological saline. Results: An optimized leaflet geometry has been developed by CAD, and further refined by FEA. Static testing of the optimized trefoil tissue pattern shows near-normal anatomy, with no prolapse or pin wheeling, and full valve competence to 90 mmHg pressure. Conclusions: An initial optimized geometry has been developed for a two-dimensional tissue pattern that can be used to reconstruct diseased semilunar heart valves with human pericardium. Optimization studies are based on the mechanical properties of the tissue, CAD to mimic normal anatomy, FEA to study stress distribution, and static load testing to confirm function.