Biomechanical evaluation of a personalized external aortic root support applied in the Ross procedure

A commonly heard concern in the Ross procedure, where a diseased aortic valve is replaced by the patient's own pulmonary valve, is the possibility of pulmonary autograft dilatation. We performed a biomechanical investigation of the use of a personalized external aortic root support or exostent as a possibility for supporting the autograft. In ten sheep a short length of pulmonary artery was interposed in the descending aorta, serving as a simplified version of the Ross procedure. In seven of these cases, the autograft was supported by an external mesh or so-called exostent. Three sheep served as control, of which one was excluded from the mechanical testing. The sheep were sacrificed six months after the procedure. Samples of the relevant tissues were obtained for subsequent mechanical testing: normal aorta, normal pulmonary artery, aorta with exostent, pulmonary artery with exostent, and pulmonary artery in aortic position for six months. After mechanical testing, the material parameters of the Gasser-Ogden-Holzapfel model were determined for the different tissue types. Stress-strain curves of the different tissue types show significantly different mechanical behavior. At baseline, stress-strain curves of the pulmonary artery are lower than aortic stress-strain curves, but at the strain levels at which the collagen fibers are recruited, the pulmonary artery behaves stiffer than the aorta. After being in aortic position for six months, the pulmonary artery tends towards aorta-like behavior, indicating that growth and remodeling processes have taken place. When adding an exostent around the pulmonary autograft, the mechanical behavior of the composite artery (exostent + artery) differs from the artery alone, the non-linearity being more evident in the former

Optimal Material Selection for Total Hip Implant: A Finite Element Case Study

The selection of most proper materials in engineering design is known as an important stage of the design process. In order to successfully complete this stage, it is necessary to have sufficient knowledge about the structure of materials, density, melting point, thermal expansion coefficient, tensile and yield strength, elongation, modulus of elasticity, hardness and many other properties. There are several selection systems that help the design engineer to choose most suitable material that meet the required properties. In the field of bioengineering, the selection of materials and the development of new materials for the clinical needs are increasingly important. In this study, the cases of optimal implant stabilization were investigated, material alternatives for hip prosthesis were evaluated, and optimal materials were determined. Using computerized tomography data with MIMICS software, virtual surgery was applied the hip bone and the implant was attached to bone. Boundary conditions and material properties have been defined, and finite element model has been created. FEA investigation of the mechanical behavior of the hip implant for various material alternatives determined by the CES software showed that the best material candidate is austenitic, annealed and biodurable stainless steel in terms of the micromotions at the implant-bone cement interface regarding osseointegration. This candidate showed 20.69% less strain value than the most commercially used hip implant material, Ti6Al4V. Therefore, the findings of this study suggest that the use of some specific stainless steel materials for implants may reduce the operation cost and increase the operation success for the total hip arthroplasty.https://doi.org/10.1007/s13369-019-04088-