Mesh manipulation for local structural property tailoring of medical warp-knitted textiles.

Medical meshes are used as structural reinforcement both in clinical surgery and tissue engineering. However, complex loading conditions often found in such applications result in a non-homogenous stress distribution, for which the uniform reinforcement provided by the meshes is not optimal. This study aims to design a textile reinforcement with a spatially heterogeneous, load-tailored fiber architecture. To this end, we developed a simple method of manipulating a standard uniform mesh by stretching in warp and weft directions to various extents in order to control fiber orientation and fiber volume fraction. Subsequent thermal treatment locked the manipulated configurations allowing further use of the meshes. Firstly, samples in five uniform configurations (two manipulated longitudinally (warp direction), two manipulated transversely (weft direction), one non-manipulated) were obtained and analyzed regarding their morphology as well as their mechanical properties under cyclic uniaxial loading. Significant effects of the manipulation on key characteristics of the pores such as angles, side lengths, aspect ratios, and fiber volume fraction were shown. Tensile testing demonstrated the range of tensile properties achievable with the simple manipulation of the mesh, not only in magnitude but also in the shape of the stress-strain response curve. Finally, local manipulation combining different mesh configurations was exemplarily applied to create a spatially heterogeneous load-tailored reinforcement to match local strain directions in tissue-engineered tubular heart valves. The proposed method enables the use of well-established uniform medical meshes to produce load-tailored non-uniform mesh reinforcement for many applications in an easy-to-implement manner.

Fluid-structure interaction simulation of artificial textile reinforced aortic heart valve: Validation with an in-vitro test.

Prosthetic heart valves deployed in the left heart (aortic and mitral) are subjected to harsh hemodynamical conditions. Most of the tissue engineered heart valves have been developed for the low pressure pulmonary position because of the difficulties in fabricating a mechanically strong valve, able to withstand the systemic circulation. This necessitates the use of reinforcing scaffolds, resulting in a tissue-engineered textile reinforced tubular aortic heart valve. Therefore, to better design these implants, material behaviour of the composite, valve kinematics and its hemodynamical response need to be evaluated. Experimental assessment can be immensely time consuming and expensive, paving way for numerical studies. In this work, the material properties obtained using the previously proposed multi-scale numerical method for textile composites was evaluated for its accuracy. An in silico immersed boundary (IB) fluid structure interaction (FSI) simulation emulating the in vitro experiment was set-up to evaluate and compare the geometric orifice area and flow rate for one beat cycle. Results from the in silico FSI simulation were found to be in good coherence with the in vitro test during the systolic phase, while mean deviation of approximately 9% was observed during the diastolic phase of a beat cycle. Merits and demerits of the in silico IB-FSI method for the presented case study has been discussed with the advantages outweighing the drawbacks, indicating the potential towards an effective use of this framework in the development and analysis of heart valves.