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Tong Q, Cai J, Wang Z, Sun Y, Liang X, Xu Q, Mahamoud OA, Qian Y, Qian Z. Recent Advances in the Modification and Improvement of Bioprosthetic Heart Valves. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309844. [PMID: 38279610 DOI: 10.1002/smll.202309844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/10/2023] [Indexed: 01/28/2024]
Abstract
Valvular heart disease (VHD) has become a burden and a growing public health problem in humans, causing significant morbidity and mortality worldwide. An increasing number of patients with severe VHD need to undergo heart valve replacement surgery, and artificial heart valves are in high demand. However, allogeneic valves from donors are lacking and cannot meet clinical practice needs. A mechanical heart valve can activate the coagulation pathway after contact with blood after implantation in the cardiovascular system, leading to thrombosis. Therefore, bioprosthetic heart valves (BHVs) are still a promising way to solve this problem. However, there are still challenges in the use of BHVs. For example, their longevity is still unsatisfactory due to the defects, such as thrombosis, structural valve degeneration, calcification, insufficient re-endothelialization, and the inflammatory response. Therefore, strategies and methods are needed to effectively improve the biocompatibility and longevity of BHVs. This review describes the recent research advances in BHVs and strategies to improve their biocompatibility and longevity.
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Affiliation(s)
- Qi Tong
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Jie Cai
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Zhengjie Wang
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Yiren Sun
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Xuyue Liang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Qiyue Xu
- School of Basic Medicine, Mudanjiang Medical University, Mudanjiang, Heilongjiang, 157011, P. R. China
| | - Oumar Abdel Mahamoud
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Yongjun Qian
- Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
| | - Zhiyong Qian
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China
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Wu Y, Chen X, Song P, Li R, Zhou Y, Wang Q, Shi J, Qiao W, Dong N. Functional Oxidized Hyaluronic Acid Cross-Linked Decellularized Heart Valves for Improved Immunomodulation, Anti-Calcification, and Recellularization. Adv Healthc Mater 2024; 13:e2303737. [PMID: 38560921 DOI: 10.1002/adhm.202303737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/09/2024] [Indexed: 04/04/2024]
Abstract
Tissue engineering heart valves (TEHVs) are expected to address the limitations of mechanical and bioprosthetic valves used in clinical practice. Decellularized heart valve (DHV) is an important scaffold of TEHVs due to its natural three-dimensional structure and bioactive extracellular matrix, but its mechanical properties and hemocompatibility are impaired. In this study, DHV is cross-linked with three different molecular weights of oxidized hyaluronic acid (OHA) by a Schiff base reaction and presented enhanced stability and hemocompatibility, which could be mediated by the molecular weight of OHA. Notably, DHV cross-linked with middle- and high-molecular-weight OHA could drive the macrophage polarization toward the M2 phenotype in vitro. Moreover, DHV cross-linked with middle-molecular-weight OHA scaffolds are further modified with RGD-PHSRN peptide (RPF-OHA/DHV) to block the residual aldehyde groups of the unreacted OHA. The results show that RPF-OHA/DHV not only exhibits anti-calcification properties, but also facilitates endothelial cell adhesion and proliferation in vitro. Furthermore, RPF-OHA/DHV shows excellent performance under an in vivo hemodynamic environment with favorable recellularization and immune regulation without calcification. The optimistic results demonstrate that OHA with different molecular weights has different cross-linking effects on DHV and that RPF-OHA/DHV scaffold with enhanced immune regulation, anti-calcification, and recellularization properties for clinical transformation.
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Affiliation(s)
- Yunlong Wu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xing Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Department of Cardiovascular Surgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, China
| | - Peng Song
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Rui Li
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Ying Zhou
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Qin Wang
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Jiawei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Weihua Qiao
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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Hascoet S, Gatzoulis MA, Fraisse A. Quest for a Lifelong Pulmonary Valve in Repaired Tetralogy of Fallot: Valve Bioengineering Is Needed. JACC Cardiovasc Interv 2024; 17:228-230. [PMID: 38127023 DOI: 10.1016/j.jcin.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Sébastien Hascoet
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Paris-Saclay, Université Paris-Saclay, Le Plessis Robinson, France; Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom; Inserm UMR-S 999, Marie Lannelongue Hospital, Paris-Saclay University, Le Plessis Robinson, France.
| | - Michael A Gatzoulis
- Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom
| | - Alain Fraisse
- Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom
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Hascoet S, Karsenty C, Fraisse A. Transcatheter Pulmonary Valve Replacement: History Is on the Move. JACC Cardiovasc Interv 2024; 17:245-247. [PMID: 38267138 DOI: 10.1016/j.jcin.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Sébastien Hascoet
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Paris-Saclay, Université Paris-Saclay, Le Plessis Robinson, France; Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom; Inserm UMR-S 999, Marie Lannelongue Hospital, Paris-Saclay University, Le Plessis Robinson, France.
| | - Clément Karsenty
- Department of Paediatric Cardiology, CHU Toulouse, Toulouse, France
| | - Alain Fraisse
- Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom
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