{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:14:56Z","timestamp":1767863696452,"version":"3.49.0"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T00:00:00Z","timestamp":1542067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Recent studies have shown that subclinical valve thrombosis in heart valve prosthesis (HVP) can be responsible for reduced leaflet motion detectable only by advanced imaging diagnostics. We conceived a novel sensorized HVP able to detect earlier any thrombus formation that may alter the leaflets motion using an electric impedance measurement, IntraValvular Impedance (IVI). Methods: For IVI measurement, dedicated electrodes are embedded in the structure of the HVP to generate a local electric field that is altered by the moving valve leaflets during their cyclic opening\/closing. We present preliminary in vitro results using a first prototype of sensorized mechanical heart valve connected to an external impedance measurement system. The prototype was tested on a circulatory mock loop system and the IVI signals were recorded during both normal dynamics and experimentally induced altered working of the leaflets. Results: Recordings showed a very repetitive and stable IVI signal during the normal cyclic opening\/closing of the HVP. The induced alterations in leaflet motion were reflected in the IVI signal. Conclusions: The novel sensorized HVP has great potential to give early warning of possible subclinical valve thrombosis altering the valve leaflet motion, and to help in tailoring the anticoagulation therapy.<\/jats:p>","DOI":"10.3390\/s18113905","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T10:58:22Z","timestamp":1542193102000},"page":"3905","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A Novel Sensorized Heart Valve Prosthesis: Preliminary In Vitro Evaluation"],"prefix":"10.3390","volume":"18","author":[{"given":"Emanuela","family":"Marcelli","sequence":"first","affiliation":[{"name":"Laboratory of Bioengineering, DIMES Department, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1240-9391","authenticated-orcid":false,"given":"Barbara","family":"Bortolani","sequence":"additional","affiliation":[{"name":"Laboratory of Bioengineering, DIMES Department, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-1978","authenticated-orcid":false,"given":"Ivan","family":"Corazza","sequence":"additional","affiliation":[{"name":"Medical Physics Activities Coordination Center, DIMES Department, University of Bologna, 40138 Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7818-1356","authenticated-orcid":false,"given":"Laura","family":"Cercenelli","sequence":"additional","affiliation":[{"name":"Laboratory of Bioengineering, DIMES Department, University of Bologna, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2018,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/nrcardio.2010.202","article-title":"Epidemiology of valvular heart disease in the adult","volume":"8","author":"Iung","year":"2011","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","first-page":"75","article-title":"The modern epidemiology of heart valve disease","volume":"102","author":"Coffey","year":"2016","journal-title":"Heart Br. Card. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0140-6736(09)60780-7","article-title":"Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends","volume":"374","author":"Sun","year":"2009","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1161\/CIRCULATIONAHA.108.778886","article-title":"Prosthetic heart valves: Selection of the optimal prosthesis and long-term management","volume":"119","author":"Pibarot","year":"2009","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1136\/hrt.2005.071183","article-title":"Thrombosis of prosthetic heart valves: Diagnosis and therapeutic considerations","volume":"93","author":"Roudaut","year":"2007","journal-title":"Heart"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1016\/j.jacc.2017.02.051","article-title":"Bioprosthetic Valve Thrombosis","volume":"69","author":"Puri","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2670","DOI":"10.1016\/j.jacc.2016.09.958","article-title":"Prosthetic Heart Valve Thrombosis","volume":"68","author":"Dangas","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","first-page":"1591","article-title":"Possible Subclinical Leaflet Thrombosis in Bioprosthetic Aortic Valves","volume":"374","author":"Makkar","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1016\/S0140-6736(17)30757-2","article-title":"Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: An observational study","volume":"389","author":"Chakravarty","year":"2017","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1016\/j.jacc.2015.09.022","article-title":"Bioprosthetic Valve Thrombosis Versus Structural Failure: Clinical and Echocardiographic Predictors","volume":"66","author":"Egbe","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1161\/CIRCULATIONAHA.116.025429","article-title":"Aortic Valve Bioprostheses: Leaflet Immobility and Valve Thrombosis","volume":"135","author":"Holmes","year":"2017","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1093\/ejcts\/ezu201","article-title":"Misconceptions, diagnostic challenges and treatment opportunities in bioprosthetic valve thrombosis: Lessons from a case series","volume":"47","author":"Pislaru","year":"2015","journal-title":"Eur. J. Cardio-Thorac. Surg. Off. J. Eur. Assoc. Cardio-Thorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/HCO.0000000000000373","article-title":"Subclinical bioprosthetic aortic valve thrombosis: Clinical and translational implications","volume":"32","author":"Yanagawa","year":"2017","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_15","first-page":"1735","article-title":"Subclinical Leaflet Thrombosis in Transcatheter Aortic Valve Replacement Detected by Multidetector Computed Tomography\u2014A Review of Current Evidence","volume":"82","author":"Rashid","year":"2018","journal-title":"Circ. J. Off. J. Jpn. Circ. Soc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jcct.2017.11.002","article-title":"Leaflet thrombosis following transcatheter aortic valve implantation","volume":"12","author":"Marwan","year":"2018","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2263","DOI":"10.1093\/eurheartj\/ehv526","article-title":"Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves","volume":"37","author":"Pache","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1038\/nrcardio.2011.71","article-title":"Diagnostic evaluation of left-sided prosthetic heart valve dysfunction","volume":"8","author":"Habets","year":"2011","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/j.jacc.2016.08.010","article-title":"Transcatheter Aortic Valve Thrombosis: Incidence, Predisposing Factors, and Clinical Implications","volume":"68","author":"Hansson","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","unstructured":"Marcelli, E. (2016). Protesi Valvolare Cardiaca con Circuito Elettronico Integrato per Effettuare Misure di Impedenza Elettrica Intravalvolare e Sistema per Monitorare la Funzionalit\u00e0 di tale Protesi. (IT2014BO00217), IT Patent."},{"key":"#cr-split#-ref_21.1","unstructured":"Marcelli, E. (2015). Heart Valve Prosthesis with Integrated Electronic Circuit for Measuring Intravalvular Electrical Impedance, and System for Monitoring Functionality of the Prosthesis. (WO2015158789 (A1)), WO Patent, CN Patent CN106456043 (A), 22 February 2017"},{"key":"#cr-split#-ref_21.2","unstructured":"U.S. Patent US9987129 (B2), 5 June 2018."},{"key":"ref_22","first-page":"399","article-title":"Intravalvular impedance sensor for next-generation smart prosthetic heart valves","volume":"38","author":"Marcelli","year":"2015","journal-title":"Int. J. Artif. Organ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1111\/j.1540-8159.1988.tb06322.x","article-title":"Rate responsive pacing using a minute ventilation sensor","volume":"11","author":"Mond","year":"1988","journal-title":"Pacing Clin. Electrophysiol. PACE"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1540-8159.1998.tb01055.x","article-title":"Measurement of minute ventilation with different DDDR pacemaker electrode configurations. Investigators of a Multicenter Study Evaluating the Chorus RM and Opus RM Pacemakers","volume":"21","author":"Bonnet","year":"1998","journal-title":"Pacing Clin. Electrophysiol. PACE"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1166\/sl.2007.086","article-title":"Magnetic Sensor for Early Detection of Heart Valve Bioprostheses Failure","volume":"5","author":"Rivero","year":"2007","journal-title":"Sens. Lett."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1007\/BF02348084","article-title":"Development and validation of implantable sensors for monitoring function of prosthetic heart valves: In vitro studies","volume":"41","author":"Lanning","year":"2003","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_27","unstructured":"Martinsen, O.G., and Grimnes, S. (2011). Bioimpedance and Bioelectricity Basics, Elsevier. [3rd ed.]."},{"key":"ref_28","first-page":"62","article-title":"Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers","volume":"2016","author":"Marcelli","year":"1992","journal-title":"ASAIO J. Am. Soc. Artif. Int. Organs"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"074301","DOI":"10.1063\/1.5030100","article-title":"How to transform a fixed stroke alternating syringe ventricle into an adjustable elastance ventricle","volume":"89","author":"Corazza","year":"2018","journal-title":"Rev. Sci. Instrum."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/18\/11\/3905\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:29:21Z","timestamp":1760196561000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/18\/11\/3905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,13]]},"references-count":30,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2018,11]]}},"alternative-id":["s18113905"],"URL":"https:\/\/doi.org\/10.3390\/s18113905","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,13]]}}}