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Melo SF, Nondonfaz A, Aqil A, Pierrard A, Hulin A, Delierneux C, Ditkowski B, Gustin M, Legrand M, Tullemans BME, Brouns SLN, Nchimi A, Carrus R, Dejosé A, Heemskerk JWM, Kuijpers MJE, Ritter J, Steinseifer U, Clauser JC, Jérôme C, Lancellotti P, Oury C. Design, manufacturing and testing of a green non-isocyanate polyurethane prosthetic heart valve. Biomater Sci 2024; 12:2149-2164. [PMID: 38487997 DOI: 10.1039/d3bm01911j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The sole effective treatment for most patients with heart valve disease is valve replacement by implantation of mechanical or biological prostheses. However, mechanical valves represent high risk of thromboembolism, and biological prostheses are prone to early degeneration. In this work, we aim to determine the potential of novel environmentally-friendly non-isocyanate polyurethanes (NIPUs) for manufacturing synthetic prosthetic heart valves. Polyhydroxyurethane (PHU) NIPUs are synthesized via an isocyanate-free route, tested in vitro, and used to produce aortic valves. PHU elastomers reinforced with a polyester mesh show mechanical properties similar to native valve leaflets. These NIPUs do not cause hemolysis. Interestingly, both platelet adhesion and contact activation-induced coagulation are strongly reduced on NIPU surfaces, indicating low thrombogenicity. Fibroblasts and endothelial cells maintain normal growth and shape after indirect contact with NIPUs. Fluid-structure interaction (FSI) allows modeling of the ideal valve design, with minimal shear stress on the leaflets. Injection-molded valves are tested in a pulse duplicator and show ISO-compliant hydrodynamic performance, comparable to clinically-used bioprostheses. Poly(tetrahydrofuran) (PTHF)-NIPU patches do not show any evidence of calcification over a period of 8 weeks. NIPUs are promising sustainable biomaterials for the manufacturing of improved prosthetic valves with low thrombogenicity.
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Affiliation(s)
- Sofia F Melo
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Alicia Nondonfaz
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Abdelhafid Aqil
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Anna Pierrard
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Alexia Hulin
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Céline Delierneux
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Bartosz Ditkowski
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Maxime Gustin
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Maxime Legrand
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Bibian M E Tullemans
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Sanne L N Brouns
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Alain Nchimi
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Raoul Carrus
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Astrid Dejosé
- Sirris, Liège Science Park, Rue du Bois Saint-Jean 12, 4102 Seraing, Belgium
| | - Johan W M Heemskerk
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Marijke J E Kuijpers
- Cardiovascular Research Institute Maastricht (CARIM), Department of Biochemistry, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, The Netherlands
| | - Jan Ritter
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Johanna C Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Christine Jérôme
- Center for Education and Research on Macromolecules (CERM), CESAM Research Unit, Department of Chemistry, University of Liège, Allée du 6 août 13, B6a, 4000 Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
| | - Cécile Oury
- Laboratory of Cardiology, GIGA-Cardiovascular Sciences, University of Liège, Avenue de l'Hôpital 11, B34, 4000 Liège, Belgium.
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Slepičková Kasálková N, Rimpelová S, Vacek C, Fajstavr D, Švorčík V, Sajdl P, Slepička P. Surface activation of Hastalex by vacuum argon plasma for cytocompatibility enhancement. Heliyon 2024; 10:e27816. [PMID: 38510028 PMCID: PMC10951612 DOI: 10.1016/j.heliyon.2024.e27816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
Here, we present surface analysis and biocompatibility evaluation of novel composite material based on graphene oxide traded as Hastalex. First, the surface morphology and elemental analysis of the pristine material were examined by atomic force and scanning electron microscopies, and by energy-dispersive and X-ray photoelectron spectroscopies, respectively. The Hastalex surface was then modified by plasma (3 and 8 W with exposure times up to 240 s), the impact of which on the material surface wettability and morphology was further evaluated. In addition, the material aging was studied at room and elevated temperatures. Significant changes in surface roughness, morphology, and area were detected at the nanometer scale after plasma exposure. An increase in oxygen content due to the plasma exposure was observed both for 3 and 8 W. The plasma treatment had an outstanding effect on the cytocompatibility of Hastalex foil treated at both input powers of 3 and 8 W. The cell number of human MRC-5 fibroblasts on Hastalex foils exposed to plasma increased significantly compared to pristine Hastalex and even to tissue culture polystyrene. The plasma exposure also affected the fibroblasts' cell growth and shape.
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Affiliation(s)
- Nikola Slepičková Kasálková
- Department of Solid State Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Silvie Rimpelová
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Cyril Vacek
- Department of Solid State Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Dominik Fajstavr
- Department of Solid State Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Václav Švorčík
- Department of Solid State Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Petr Sajdl
- Department of Power Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Petr Slepička
- Department of Solid State Engineering, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
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Baylous K, Helbock R, Kovarovic B, Anam S, Slepian M, Bluestein D. In silico fatigue optimization of TAVR stent designs with physiological motion in a beating heart model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107886. [PMID: 37925854 DOI: 10.1016/j.cmpb.2023.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND OBJECTIVE The rapid expansion of TAVR to younger, low-risk patients raises concerns regarding device durability. Necessarily, extended stent lifetime will become more critical for new generation devices. In vitro methods commonly used for TAVR stent fatigue testing exclude the effects of the beating heart. We present a more realistic in silico stent fatigue analysis utilizing a beating heart model in which TAVR stents experience complex, nonuniform dynamic loading. METHODS Virtual TAVR deployments were simulated in the SIMULIA Living Heart Human Model of a beating heart using stent models of the self-expandable nitinol 26-mm CoreValve and Evolut R devices, and a 27-mm PolyV-2. Stent deformation was monitored over three cardiac cycles, and fatigue resistance was evaluated for the nitinol stents using finite element analysis via ABAQUS/Explicit. The average strain and strain amplitude of each stent element were tracked, and established thresholds were applied to determine potential fatigue failure. Fatigue performance of control stents was compared to parametrically modified models with a 20% increase or decrease in strut width. RESULTS Stents with reduced strut width applied lower radial force against the contracting myocardium of the beating heart, resulting in larger displacements and higher strain values. Formulas relating in vivo strain to stent design do not account for this. In all models, there were elements in which strains exceeded fatigue failure. The PolyV-2 stent had far fewer failing elements since its struts were optimized to reduce the strain in stent joints, achieving better fatigue resistance in the stent crown and waist elements. Different stent sections showed markedly different fatigue resistance due to the varying loading conditions. CONCLUSIONS Our analysis indicates that previous studies underestimate strain amplitudes that may cause stent failure. This study demonstrates the utility of advanced in silico analysis of devices deployed within a beating heart that mimics in vivo loading, offering a cost-effective alternative to human or animal trials and establishing a platform to assess the impact of device design on device durability. The limited fatigue life of TAVR stents indicated here highlights a clinical complication that may eventually develop as younger, lower-risk TAVR patients, age.
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Affiliation(s)
- Kyle Baylous
- Department of Biomedical Engineering, Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8084, USA
| | - Ryan Helbock
- Department of Biomedical Engineering, Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8084, USA
| | - Brandon Kovarovic
- Department of Biomedical Engineering, Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8084, USA
| | - Salwa Anam
- Department of Biomedical Engineering, Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8084, USA
| | - Marvin Slepian
- Department of Medicine and Biomedical Engineering Sarver Heart Center, University of Arizona, Tucson, AZ 85721, USA
| | - Danny Bluestein
- Department of Biomedical Engineering, Stony Brook University, Health Sciences Center, Stony Brook, NY 11794-8084, USA.
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Zeng L, Liu F, Yu Q, Jin C, Yang J, Suo Z, Tang J. Flaw-insensitive fatigue resistance of chemically fixed collagenous soft tissues. SCIENCE ADVANCES 2023; 9:eade7375. [PMID: 36867693 PMCID: PMC9984180 DOI: 10.1126/sciadv.ade7375] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Bovine pericardium (BP) has been used as leaflets of prosthetic heart valves. The leaflets are sutured on metallic stents and can survive 400 million flaps (~10-year life span), unaffected by the suture holes. This flaw-insensitive fatigue resistance is unmatched by synthetic leaflets. We show that the endurance strength of BP under cyclic stretch is insensitive to cuts as long as 1 centimeter, about two orders of magnitude longer than that of a thermoplastic polyurethane (TPU). The flaw-insensitive fatigue resistance of BP results from the high strength of collagen fibers and soft matrix between them. When BP is stretched, the soft matrix enables a collagen fiber to transmit tension over a long length. The energy in the long length dissipates when the fiber breaks. We demonstrate that a BP leaflet greatly outperforms a TPU leaflet. It is hoped that these findings will aid the development of soft materials for flaw-insensitive fatigue resistance.
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Affiliation(s)
- Liangsong Zeng
- State Key Lab for Strength and Vibration of Mechanical Structures, International Center for Applied Mechanics, Department of Engineering Mechanics, Xi’an Jiaotong University, Xi’an, China
| | - Fengkai Liu
- State Key Lab for Strength and Vibration of Mechanical Structures, International Center for Applied Mechanics, Department of Engineering Mechanics, Xi’an Jiaotong University, Xi’an, China
| | - Qifeng Yu
- Shanghai NewMed Medical Corporation, Shanghai, China
| | - Chenyu Jin
- State Key Lab for Strength and Vibration of Mechanical Structures, International Center for Applied Mechanics, Department of Engineering Mechanics, Xi’an Jiaotong University, Xi’an, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi’an 710032, China
| | - Zhigang Suo
- John A. Paulson School of Engineering and Applied Sciences, Kavli Institute for Bionano Science and Technology, Harvard University, Cambridge, MA, USA
| | - Jingda Tang
- State Key Lab for Strength and Vibration of Mechanical Structures, International Center for Applied Mechanics, Department of Engineering Mechanics, Xi’an Jiaotong University, Xi’an, China
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Rezvova MA, Klyshnikov KY, Gritskevich AA, Ovcharenko EA. Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices. Int J Mol Sci 2023; 24:ijms24043963. [PMID: 36835389 PMCID: PMC9967268 DOI: 10.3390/ijms24043963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
The development of a novel artificial heart valve with outstanding durability and safety has remained a challenge since the first mechanical heart valve entered the market 65 years ago. Recent progress in high-molecular compounds opened new horizons in overcoming major drawbacks of mechanical and tissue heart valves (dysfunction and failure, tissue degradation, calcification, high immunogenic potential, and high risk of thrombosis), providing new insights into the development of an ideal artificial heart valve. Polymeric heart valves can best mimic the tissue-level mechanical behavior of the native valves. This review summarizes the evolution of polymeric heart valves and the state-of-the-art approaches to their development, fabrication, and manufacturing. The review discusses the biocompatibility and durability testing of previously investigated polymeric materials and presents the most recent developments, including the first human clinical trials of LifePolymer. New promising functional polymers, nanocomposite biomaterials, and valve designs are discussed in terms of their potential application in the development of an ideal polymeric heart valve. The superiority and inferiority of nanocomposite and hybrid materials to non-modified polymers are reported. The review proposes several concepts potentially suitable to address the above-mentioned challenges arising in the R&D of polymeric heart valves from the properties, structure, and surface of polymeric materials. Additive manufacturing, nanotechnology, anisotropy control, machine learning, and advanced modeling tools have given the green light to set new directions for polymeric heart valves.
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Affiliation(s)
- Maria A. Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
| | - Kirill Y. Klyshnikov
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
| | | | - Evgeny A. Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, 650002 Kemerovo, Russia
- Correspondence:
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Bui HT, Ishrat A, James SP, Dasi LP. Design consideration of a novel polymeric transcatheter heart valve through computational modeling. J Mech Behav Biomed Mater 2022; 135:105434. [PMID: 36116342 DOI: 10.1016/j.jmbbm.2022.105434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
Transcatheter heart valve replacement is becoming a more routine procedure, and this is further supported by positive outcomes from studies involving low-risk patients. Nevertheless, the lack of long-term transcatheter heart valve (TAV) durability is still one of the primary concerns. As a result, more research has been focused on improving durability through various methods such as valve design, computational modeling, and material selection. Recent advancements in polymeric valve fabrication showed that linear low-density polyethylene (LLDPE) could be used as leaflet material for transcatheter heart valves. In this paper, a parametric study of computational simulations showed stress distribution on the leaflets of LLDPE-TAV under diastolic load, and the results were used to improve the stent design. The in silico experiment also tested the effect of shock absorbers in terms of valve durability. The results demonstrated that altering specific stent angles can significantly lower peak stress on the leaflets (13.8 vs. 6.07 MPa). Implementing two layers of shock absorbers further reduces the stress value to 4.28 MPa. The pinwheeling index was assessed, which seems to correlate with peak stress. Overall, the parametric study and the computational method can be used to analyze and improve valve durability.
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Affiliation(s)
- Hieu T Bui
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA
| | - Amina Ishrat
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA
| | - Susan P James
- School of Advanced Materials Discovery, Colorado State University, 700 Meridian Ave, Fort Collins, CO, 80523, USA
| | - Lakshmi Prasad Dasi
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA.
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Chakrabarti M, Bhattacharya A, Gebere MG, Johnson J, Ayub ZA, Chatzistamou I, Vyavahare NR, Azhar M. Increased TGFβ1 and SMAD3 Contribute to Age-Related Aortic Valve Calcification. Front Cardiovasc Med 2022; 9:770065. [PMID: 35928937 PMCID: PMC9343688 DOI: 10.3389/fcvm.2022.770065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/20/2022] [Indexed: 12/01/2022] Open
Abstract
Aims Calcific aortic valve disease (CAVD) is a progressive heart disease that is particularly prevalent in elderly patients. The current treatment of CAVD is surgical valve replacement, but this is not a permanent solution, and it is very challenging for elderly patients. Thus, a pharmacological intervention for CAVD may be beneficial. In this study, we intended to rescue aortic valve (AV) calcification through inhibition of TGFβ1 and SMAD3 signaling pathways. Methods and Results The klotho gene, which was discovered as an aging-suppressor gene, has been observed to play a crucial role in AV calcification. The klotho knockout (Kl–/–) mice have shorter life span (8–12 weeks) and develop severe AV calcification. Here, we showed that increased TGFβ1 and TGFβ-dependent SMAD3 signaling were associated with AV calcification in Kl–/– mice. Next, we generated Tgfb1- and Smad3-haploinsufficient Kl–/– mice to determine the contribution of TGFβ1 and SMAD3 to the AV calcification in Kl–/– mice. The histological and morphometric evaluation suggested a significant reduction of AV calcification in Kl–/–; Tgfb1± mice compared to Kl–/– mice. Smad3 heterozygous deletion was observed to be more potent in reducing AV calcification in Kl–/– mice compared to the Kl–/–; Tgfb1± mice. We observed significant inhibition of Tgfb1, Pai1, Bmp2, Alk2, Spp1, and Runx2 mRNA expression in Kl–/–; Tgfb1± and Kl–/–; Smad3± mice compared to Kl–/– mice. Western blot analysis confirmed that the inhibition of TGFβ canonical and non-canonical signaling pathways were associated with the rescue of AV calcification of both Kl–/–; Tgfb1± and Kl–/–; Smad3± mice. Conclusion Overall, inhibition of the TGFβ1-dependent SMAD3 signaling pathway significantly blocks the development of AV calcification in Kl–/– mice. This information is useful in understanding the signaling mechanisms involved in CAVD.
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Affiliation(s)
- Mrinmay Chakrabarti
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - Aniket Bhattacharya
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
- Department of Neuroscience and Cell Biology, Child Health Institute of New Jersey Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Mengistu G. Gebere
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - John Johnson
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - Zeeshan A. Ayub
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - Ioulia Chatzistamou
- Department of Pathology, Microbiology, and Immunology, School of Medicine, University of South Carolina, Columbia, SC, United States
| | | | - Mohamad Azhar
- Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States
- William Jennings Bryan Dorn VA Medical Center, Columbia, SC, United States
- *Correspondence: Mohamad Azhar,
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Qi X, Jiang Z, Song M, Tang Z, Xie X, Liu Y, Wu Q, Wu Z. A Novel Crosslinking Method for Improving the Anti-Calcification Ability and Extracellular Matrix Stability in Transcatheter Heart Valves. Front Bioeng Biotechnol 2022; 10:909771. [PMID: 35903798 PMCID: PMC9315440 DOI: 10.3389/fbioe.2022.909771] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/08/2022] [Indexed: 12/12/2022] Open
Abstract
More than 200,000 patients with aortic diseases worldwide undergo surgical valve replacement each year, and transcatheter heart valves (THV) have been more widely used than ever before. However, THV made by the glutaraldehyde (Glut) crosslinking method has the disadvantage of being prone to calcification, which significantly reduces the durability of biomaterials. In this study, we applied a novel crosslinking method using ribose in THV for the first time, which can decrease calcification and increase the stability of the extracellular matrix (ECM). We incubated the bovine pericardium (BP) in ribose solution at 37°C by shaking for 12 days and confirmed that the structure of the BP was more compact than that of the Glut group. Moreover, the ribose method remarkably enhanced the biomechanical properties and provided reliable resistance to enzymatic degradation and satisfactory cellular compatibility in THV. When the BP was implanted subcutaneously in vivo, we demonstrated that ECM components were preserved more completely, especially in elastin, and the immune-inflammatory response was more moderate than that in the Glut treatment group. Finally, the ribose-cross-linked materials showed better anti-calcification potential and improved durability of THV than Glut-cross-linked materials.
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9
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Comparison of performance of self-expanding and balloon-expandable transcatheter aortic valves. JTCVS OPEN 2022; 10:128-139. [PMID: 36004225 PMCID: PMC9390782 DOI: 10.1016/j.xjon.2022.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022]
Abstract
Objective Methods Results Conclusions
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