A novel tissue treatment to reduce mineralization of bovine pericardial heart valves

Meuris, Bart; Praetere, Herbert De; Strasly, Marina; Trabucco, Piero; Lai, John Chi Keung; Verbrugghe, Peter; Herijgers, Paul

doi:10.1016/j.jtcvs.2018.01.099

Cited by 44 publications

(41 citation statements)

References 12 publications

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“…The results of Meuris and colleagues, 4 however, fall short in validating this theoretic excitement, as I shall elucidate. The phospholipid content in the tissue treated with FREE treatment was equivalent to that of Linx (>60% volume ethanol treatment to remove phospholipids, marketed by St Jude Medical and used in Trifecta [St Jude Medical Inc, St Paul, Minn]) and Thermafix (heat treatment to denature proteins and phospholipids, marketed by Edwards Lifesciences and used in Perimount [Irvine, Calif]).…”

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confidence: 85%

“…Ultimately, lack of tissue durability is the weakest link, whether a valve is deployed surgically or through a catheter, and the current fervor surrounding the delivery mode should not mask research in this area. I therefore congratulate Meuris and colleagues 4 for their study.…”

mentioning

confidence: 92%

“…Calcification of bioprosthetic heart valves could occur from external patient-specific factors (eg, hyperlipidemia, chronic kidney disease, young age) or from internal valve material-specific factors (eg cellular remnants, calcium entrenchment into phospholipids in the cellular remnants, traces of free glutaraldehyde), or from unknown interactions between both types of factor. In their publication in this issue of the Journal , Meuris and colleagues 4 report the efficacy of the LivaNova FREE treatment (LivaNova PLC, London, United Kingdom), which involves octanediol-ethanol to remove phospholipids in the cellular remnants, a taurine wash to neutralize unbound aldehydes left after glutaraldehyde fixation, and storage in an aldehyde-free solution containing preservatives such as parabens. The logic behind this treatment strategy is sound.…”

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confidence: 99%

“…Pathak and associates 7 demonstrated the benefit of such a treatment in reducing tissue calcification, with possibly better outcomes with use of octanediol in an ethanol solution than with ethanol alone. Meuris and colleagues 4 used this technique reported by Pathak and associates, 7 and as such are not innovative in this regard. In the next step, Meuris and colleagues 4 detoxify the tissue with taurine (also known as aminoethane sulfonic acid), which has an amine group (NH 2 ) to bond with the aldehyde group of any unconjugated glutaraldehyde left after tissue fixation.…”

mentioning

confidence: 99%

“…Meuris and colleagues 4 used this technique reported by Pathak and associates, 7 and as such are not innovative in this regard. In the next step, Meuris and colleagues 4 detoxify the tissue with taurine (also known as aminoethane sulfonic acid), which has an amine group (NH 2 ) to bond with the aldehyde group of any unconjugated glutaraldehyde left after tissue fixation. It is possible that the combination of phospholipid repletion and subsequent treatment with taurine, may allow better penetration of the taurine into the tissue and aid in better outcomes.…”

mentioning

confidence: 99%

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A heart valve is no stronger than its weakest link: The need to improve durability of pericardial leaflets

Padala

2018

The Journal of Thoracic and Cardiovascular Surgery

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confidence: 85%

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confidence: 92%

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confidence: 99%

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confidence: 99%

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A heart valve is no stronger than its weakest link: The need to improve durability of pericardial leaflets

Padala

2018

The Journal of Thoracic and Cardiovascular Surgery

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Functional Oxidized Hyaluronic Acid Cross‐Linked Decellularized Heart Valves for Improved Immunomodulation, Anti‐Calcification, and Recellularization

Wu,

Chen,

Song

et al. 2024

Adv Healthcare Materials

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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 was 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, OHA/DHV scaffolds were further modified with RGD‐PHSRN peptide (RPF‐OHA/DHV) to block the residual aldehyde groups of the unreacted OHA. The results showed that RPF‐OHA/DHV not only exhibited anti‐calcification properties, but also facilitated endothelial cell adhesion and proliferation in vitro. Furthermore, RPF‐OHA/DHV showed excellent performance under an in vivo hemodynamic environment with favorable recellularization and immune regulation without calcification. The optimistic results demonstrated 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.This article is protected by copyright. All rights reserved

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Tissue response, macrophage phenotype, and intrinsic calcification induced by cardiovascular biomaterials: Can clinical regenerative potential be predicted in a rat subcutaneous implant model?

Cramer

Chang

et al. 2021

J Biomedical Materials Res

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The host immune response to an implanted biomaterial, particularly the phenotype of infiltrating macrophages, is a key determinant of biocompatibility and downstream remodeling outcome. The present study used a subcutaneous rat model to compare the tissue response, including macrophage phenotype, remodeling potential, and calcification propensity of a biologic scaffold composed of glutaraldehyde‐fixed bovine pericardium (GF‐BP), the standard of care for heart valve replacement, with those of an electrospun polycarbonate‐based supramolecular polymer scaffold (ePC‐UPy), urinary bladder extracellular matrix (UBM‐ECM), and a polypropylene mesh (PP). The ePC‐UPy and UBM‐ECM materials induced infiltration of mononuclear cells throughout the thickness of the scaffold within 2 days and neovascularization at 14 days. GF‐BP and PP elicited a balance of pro‐inflammatory (M1‐like) and anti‐inflammatory (M2‐like) macrophages, while UBM‐ECM and ePC‐UPy supported a dominant M2‐like macrophage phenotype at all timepoints. Relative to GF‐BP, ePC‐UPy was markedly less susceptible to calcification for the 180 day duration of the study. UBM‐ECM induced an archetypical constructive remodeling response dominated by M2‐like macrophages and the PP caused a typical foreign body reaction dominated by M1‐like macrophages. The results of this study highlight the divergent macrophage and host remodeling response to biomaterials with distinct physical and chemical properties and suggest that the rat subcutaneous implantation model can be used to predict in vivo biocompatibility and regenerative potential for clinical application of cardiovascular biomaterials.

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A novel tissue treatment to reduce mineralization of bovine pericardial heart valves

Abstract: The new FREE treatment combines an adequate phospholipid reduction and aldehyde neutralization with storage in an aldehyde-free solution. This combination enhances the anticalcification properties and may thereby improve long-term durability of the tissue.

Cited by 44 publications

References 12 publications

A heart valve is no stronger than its weakest link: The need to improve durability of pericardial leaflets

A heart valve is no stronger than its weakest link: The need to improve durability of pericardial leaflets

Functional Oxidized Hyaluronic Acid Cross‐Linked Decellularized Heart Valves for Improved Immunomodulation, Anti‐Calcification, and Recellularization

Tissue response, macrophage phenotype, and intrinsic calcification induced by cardiovascular biomaterials: Can clinical regenerative potential be predicted in a rat subcutaneous implant model?

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