Hydrogels Water-swollen, crosslinked polymeric structures
producedby•Reaction of one or moremonomers •Association
Mechanical heart valves Caged BallDesign The ball valve
was the first mechanical heart valveused and designed by
CharlesHufnagel•The Starr-Edwards ball valve was first used
clinically asa mitral valve replacement in1960•After the Starr-
Edwards valve was established, several other design variations
were created such asMagovern–Cromie, DeBakey–Surgitool, and
Smeloff–Cutter ball valves•Natural heart valves allow blood to
flow straightthrough the center of thevalve-This property is known
as central flow, which keepsthe amount of work done by the heart
to aminimum Tilting DiscValves•In the mid-1960s, a new class of
prosthetic valves were designed that used a tilting disc to better
mimic thenatural patterns of bloodflow •The tilting-disc valves
have a polymer disc held in placeby two weldedstruts •The titling-
disc valves open at an angle of 60°and closeshut completely at a
rateof70times/minute •This tilting pattern provides improved
central flowwhile still preventingbackflow. •The tilting-disc valves
reduce mechanical damage to blood cells. This improved flow
pattern reduced blood clottingand infectionMedtronic-Hall single
tilting diskvalve•It has a Teflon sewing ring, and titanium housing
machined from solid cylinder anda carbon-coated disk with flat
parallelsides.•The disk which opens to 75 degree in the aortic
model and 70 in the mitral, is retainedby an S shaped guide strut
that protrudes through a hole in the center of the disk
Bioprosthetic heart valves are dividedinto: •Heterografts (from
anotherspecies) •Allografts/Homografts (human cadever)
The design of bioprosthetic valves are closer to the design of the
naturalvalve. Bioprosthetic valves do not require long-term
anticoagulants, have better hemodynamics, do not cause damage
to blood cells, and do not suffer from many of the structural
problems experienced by the mechanical heartvalves
Molecular Mechanism of Cell-to-Surface Adhesion
Bacterial particles less than 1 micron are initially considered to
behave as colloidsystems•The outer layer of the implant or foreign
body is not completely saturated at the surface as it may contain
oxide layers & essentially the grainboundaries•These
heterogeneities are high energy sites serving as preferable sites for
binding owing to their high bindingenergies•The substrate & the
cell surface is usually negatively charged causing repulsion
•Hydrophobicityinbetweenthebacteria&thesubstrateleadstostron
gattractioninbetweenthemattractivebacteriumfewnanometersfro
msurface
bonds (hydrogen bond, Van Der Waals bonds in betweenchains)
Incomparison too the rsynthetic biomaterials,hydrogels resemble
ecloselyto living issues because of theirh igh water
content,soft&rubberyconsistency Hydrogels show minimal
tendency to absorb proteins from body fluids because of their low
interfacial tension Ability of molecules of various sizes to diffuse in
& out of a hydrogel makes it a possible drug delivery system for
oral, nasal, buccal, ocular, etc. routes ofadministration
Classification of Hydrogels HomopolymerHydrogel:
Cross-linked networks of sametypeofhydrophilic monomerunit
•Copolymerhydrogel:Cross-linked networks of two types of
monomer units, out of which one must behydrophilic
•Multipolymerhydrogels: Produced by cross-linking of two or
more types ofcomonomers •Interpenetratinghydrogel: A polymer
comprising two or more networks which are at least partially
interlaced on a molecular scale but not covalently bonded to each
other and cannot be separated unless chemical bonds are broken.
Classification of Hydrogels(contd.)
Types of Bio ceramics
Relatively Inert (Non-absorbable)Bioceramics
1.Carbon
Non-inert Bioceramics (Resorbable) Bioceramics
1.Calciumphosphate 2.Calcium sulfate, including plaster ofParis
3.Hydroxyapatite 4.T ricalciumphosphate 5.Ferric-calcium-
phosphorousoxides 6.Corals Surface Reactive (Semi-
inert)Bioceramics 1.Glass ceramics 2.Hydroxyapatite 3.Dense non
porous glasses
Bone structure
Thehardouterlayerofbonesiscomposedofcompactbonetissue.Its
porosityis50%.Thistissuegivesbonestheirsmooth,white,andsolidap
pearance,andaccountsfor80%ofthetotalbonemassofanadultskelet
on.Compact bone may also be referred to as dense bone
Fillingtheinterioroftheboneisthetrabecularbonetissue(anopencellp
orousnetworkalsocalledcancellousorspongybone),whichiscompos
edofanetworkofrod-andplate-like
elementsthatmaketheoverallorganlighterandallowroomforbloodv
esselsandmarrow.Trabecularboneaccountsfortheremaining20%oft
otalbonemassbuthasnearlytentimesthesurfaceareaofcompactbon
e.Itsporosityis3090%.Themicroscopicdifferencebetweencompacta
ndcancellousboneisthatcompactboneconsistsofhaversiansitesand
osteons,whilecancellousbonesdonot.Also,bonesurroundsbloodint
hecompactbone,while blood surrounds bone in thcancellousbone.
Proteins are important class of biological
macromolecules which are the polymers of aminoacids
Insoluble proteins•Regular in amino acid composition &
3Dstructure•Not free to diffuse to implant surface
•Example: collagen (forming the structure of the
tissue)•Deposited as fibrous form adjacent to or on implantby
cells as a foreign bodycapsule SolubleProteins •Less regular in
amino acid composition &3D structure as compared to
insolubleproteins •Example: blood plasma (primarily involvedin
adsorption to implanted surface) There are 20 common
aminoacids.•Amino acids share a common structure except for
one chemical group (R, side chain) attached to the central
carbonatom.•The 20 different R groups give amino acid individual
characteristics.•The sequence of different amino acids will then
give each protein unique characteristics.