Development of bioinspired hyaluronan enhanced synthetic polymers for medical applications
Date
2023
Journal Title
Journal ISSN
Volume Title
Abstract
The first transcatheter aortic valve replacement (TAVR) was performed in 2002, and over the past two decades has become as prevalent as surgical aortic valve replacements in America. TAVR's have significant potential to provide relief for patients with aortic valve disease, but due to their high cost remain accessible primarily in wealthy nations. Furthermore, TAVR's have limited lifespans and are radiotransparent so they can only be evaluated for function through echocardiography. Thus, an expensive medical implant with limited durability is only replaced after it has begun to fail and cause the patient further stress on their heart. To address these issues this dissertation reviews the research performed in generating a novel heart valve leaflet material that is radiopaque, made primarily out of linear low-density polyethylene (LLDPE), and incorporates the biological polymer hyaluronan (HA). These leaflets could significantly reduce the cost of TAVR's potentially allowing for global adoption of the technology. They are radiopaque and easily imaged using x-ray fluoroscopy allowing changes in leaflet shape or movement to be identified prior to when the echocardiography would have shown a deleterious effect to function. They incorporate HA which is found in the interior lumen of blood vessels and has been shown to decrease calcification and thrombosis, both of which have caused polymeric leaflets to fail in previous research. Finally, they can be easily shaped and reinforced allowing for a potentially far greater device lifespan. The leaflets are made by melt pressing in radiopaque powders of either tungsten or bismuth trioxide into sheets of LLDPE followed by treatment with HA to form an interpenetrating polymer network. The material properties of the leaflets were evaluated for their tensile mechanical properties, their hydrophilicity, their radio transparency (or lack thereof), and their hemodynamics. The biocompatibility of the leaflets was evaluated through a cytotoxicity assay, whole blood clotting on the surface of the material, and the ability for platelets to adhere and activate on the material surface. The results demonstrate the material has significant potential to function as a heart valve leaflet in a TAVR. Beyond evaluating this novel material, the process by which HA is incorporated into LLDPE was examined and optimized for commercial scale up. First, the need for solvent distillation and nitrogen blankets during treatment were determined to be unnecessary to produce an HA IPN with LLDPE. Then the rate at which the LLDPE is drawn from the HA solution as well as the vacuum pressure and temperature during this process was found to affect the amount of active HA at the surface of the material. Finally initial evidence was found that shows that HA IPN does not form through the bulk of the material, but rather in the first few microns of the LLDPE. Unrelated to TAVR's a study was performed to enhance the non-woven polypropylene used in surgical masks and N-95 masks against COVID-19 using HA and polyethylene glycol (PEG). HA was used to form a microcomposite on the surface of the non-woven polypropylene while PEG was grafted to the surface with oxygen plasma. The resulting materials were evaluated for their tensile mechanical properties, breathability, chemical composition, hydrophilicity, cytotoxicity, and ability to adsorb COVID-19 spike protein. The results indicate the material has notable potential to make masks more effective at preventing the transfer of COVID-19, however further studies using live SARS-CoV-2 virus beyond the capabilities of this laboratory are necessary before that potential can be fully confirmed.
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Embargo expires: 08/28/2025.
Subject
COVID-19
hyaluronan
radiopaque
heart valve
biomedical
polymer