The
aging population and the development of transcatheter aortic
valve replacement (TAVR) technology largely expand the usage of bioprosthetic
heart valves (BHVs) in patients. Almost all of the commercial BHVs
are treated with glutaraldehyde (GA). However, the GA-treated BHVs
display the drawbacks such as extracellular matrix (ECM) degradation,
cytotoxicity, immune response, and calcification. In this study, radical
polymerization reaction, a powerful tool commonly used in preparing
polymers and hydrogels, has been developed to fix decellularized ECM
instead of GA treatment. Porcine pericardium (PP) is taken as an example
of ECM for BHVs fabrication to investigate the impact of radical polymerization
on the tissue properties. The radical polymerization method better
stabilizes collagen and elastin of PP than GA treatment and produces
a soft biomaterial more like the native heart valve. Furthermore,
radical polymerization cross-linked PP exhibits excellent cytocompatibility.
After implanted subcutaneously in rats for 30 days, radical polymerization
cross-linked PP shows better elastin stability, mitigated immune response,
and reduced calcification than GA-PP. All these results suggest that
radical polymerization is an ideal cross-linking method for BHVs or
tissue engineering heart valve scaffolds and it also has the potential
for creating a variety of ECM–polymer hybrid biomaterials in
the future.
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