Fatigue-induced changes to the biaxial mechanical properties of glutaraldehyde-fixed porcine aortic valve leaflets.

Circumferential extension is a direct measure of the preservation of functional collagen crimp in the fibrosal layer of aortic valve leaflets. The aim of this study was to determine whether the elastic properties of zero-pressure, glutaraldehyde-fixed leaflets are changed by mechanical fatigue. Nine Medtronic Freestyle bioprostheses were subjected to 200x10(6) cycles of accelerated fatigue and then biaxially tested to quantify the elastic properties of the leaflets. At physiological load (60 Nm(-1)) the radial extensibility was approximately halved relative to controls (P<10(-4)); there were also lesser reductions in the circumferential extensions (P<.01). The pulsatile regurgitant volume showed no change relative to the control leaflets. The natural corrugations of the fibrosal layer were flattened by the fatigue cycling, but this was not related to an increase in the radial size of the leaflets. Valve competency was maintained.