Calcification Assessment of Bioprosthetic Heart Valve Tissues Using an ImprovedIn VitroModel

Abstract

Calcification is a recurrent problem in patients suffering from heart valve disease and it is the main cause of failure in biological heart valve prostheses. The development of reliable calcification tests that consider both the material properties of the prostheses and the fluid composition is of paramount importance for the effective testing and subsequent selection of new cardiovascular implants. In this work, a fast, reliable and highly reproducible method for the assessment of the calcification potential of biomaterials was developed. The developed method simulated closely the chemical environment in vivo, where the supersaturation levels of calcium and phosphate remain constant. Seeded hydroxyapatite (HAP) crystal growth experiments were used as the reference system and compared to the mineralization kinetics and extent of frozen untreated bovine and porcine pericardium, and glutaraldehyde-fixed bovine pericardium. Untreated pericardial patches did not calcify in the supersaturated calcium phosphate solutions whereas glutaraldehyde-fixed bovine pericardial patches mineralized at the same conditions. The present work suggested that the loose collagenous serosa side of the pericardium mineralized at lower rates compared to its dense collagenous fibrous side. Concordant with these findings, the mineralization of bioprostheses may also be attributed, to the structural deterioration of collagen-rich tissues, induced by chemical treatment used to control in vivo structural stability and immunomodulation of the implants.

Arginine-grafted porcine pericardium by copolymerization to improve the cytocompatibility, hemocompatibility and anti-calcification properties of bioprosthetic heart valve materials

“…Apoptotic cell fragments provide additional calcium binding sites, further triggering the calcification of the BHV. 13,14 Good cytocompatibility could be beneficial for reducing leaflet calcification. The cytotoxicity assay indicated that there was no cytotoxicity of pLy-GA-Arg, which may be due to the absence of cytotoxic aldehyde residues on the surface of pLy-GA-Arg.…”

“…[10][11][12] Apoptotic cell fragments provide additional calcium binding sites, further triggering the calcification of BHVs. 13,14 Although BHVs are less thrombogenic than MHVs, many studies have reported that thrombosis is still one of the important factors leading to the failure of BHVs. [15][16][17] These defects mentioned above will cause structural valve deterioration, shortening the service life of BHVs.…”

Immunological Risk Assessment of Xenogeneic Dural Patch by Comparing with Raw Material via GTKO Mice

“…ECM has many unique advantages, such as good biocompatibility, excellent biomechanical properties, and rich in cell growth factors [ 33 – 35 ]. However, the immune response caused by ECM, such as DNA, α -Gal epitope, or residual glutaraldehyde [ 36 , 37 ], should not be ignored. Currently, it is not clear whether there is a threshold of Gal epitope stimulation in the immune response of xenotransplantation induced by α -Gal epitope.…”

“…ECM has many unique advantages, such as good biocompatibility, excellent biomechanical properties, and rich in cell growth factors [33][34][35]. However, the immune response caused by ECM, such as DNA, α-Gal epitope, or residual glutaraldehyde [36,37],…”

Cross-Linking Porcine Pericardium by 3,4-Dihydroxybenzaldehyde: A Novel Method to Improve the Biocompatibility of Bioprosthetic Valve

“…Glutaraldehyde cross-linked BHVs are liable to be calcified after being implanted into patients. Although the mechanism of in vivo calcification was not yet completely understood, it was reported that postoperative valvular calcification might be related to topical inflammatory reactions provoked by the cytotoxicity of GLUT and the affinity toward calcium of residual aldehyde groups within BHVs . Unlike GLUT, DHBA has been proved to have an anti-inflammatory effect. − The experiment results revealed that the anticalcification performance of DHBA-PP was improved compared to GLUT-PP, which might be related to the reduction in the affinity to calcium of quinone oxidized from a portion of catechol …”