Transcatheter Heart Valves: A Biomaterials Perspective

Bui, Hieu T.; Khair, Nipa; Yeats, Breandan; Gooden, Shelley; James, Susan P.; Dasi, Lakshmi Prasad

doi:10.1002/adhm.202100115

Cited by 15 publications

(13 citation statements)

References 249 publications

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“…Over the past decade, several studies have reported the successes and failures in the development of an ideal polymeric heart valve [ 15 , 18 , 24 ]. However, they are focused on describing the designs of PHVs with little attention paid to polymers, their properties, composition, and surface.…”

Section: Introductionmentioning

confidence: 99%

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Резвова

Klyshnikov

Грицкевич³

et al. 2023

IJMS

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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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Section: Introductionmentioning

confidence: 99%

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Резвова

Klyshnikov

Грицкевич³

et al. 2023

IJMS

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“…Valve replacement surgery is the first choice for patients with heart valve diseases ( Brown et al, 2009 ). Every year, more than 200,000 aortic valve replacement surgeries occur globally, and the use of transcatheter heart valves (THV) has increased significantly in the past 20 years ( Bui et al, 2021 ). With the popularization of transcatheter aortic valve replacement (TAVR) technology, a THV exhibits excellent hemodynamic characteristics and provides a safe and minimally invasive means ( Paradis et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, transcatheter delivery requires THV to be crimped before deployment, as the valves often undergo additional mechanical stresses which would reduce the durability of THV. ( Schoen and Levy, 2005 ; Rodriguez-Gabella et al, 2017 ; Bui et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

A Novel Crosslinking Method for Improving the Anti-Calcification Ability and Extracellular Matrix Stability in Transcatheter Heart Valves

Jiang

Song

et al. 2022

Front. Bioeng. Biotechnol.

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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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“…The aortic valve (AV) calcification affects 25% of the population over 65 years of age and about 50% of those over 85 years ( 2 ). Surgical valve replacement is the most effective treatment for valvular heart disease ( 6 ). Old age and chronic kidney disease (CKD) are important risk factors for CAVD ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

Increased TGFβ1 and SMAD3 Contribute to Age-Related Aortic Valve Calcification

Chakrabarti

Bhattacharya

Gebere

et al. 2022

Front. Cardiovasc. Med.

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AimsCalcific 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 ResultsThe 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.ConclusionOverall, 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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Transcatheter Heart Valves: A Biomaterials Perspective

Cited by 15 publications

References 249 publications

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

Polymeric Heart Valves Will Displace Mechanical and Tissue Heart Valves: A New Era for the Medical Devices

A Novel Crosslinking Method for Improving the Anti-Calcification Ability and Extracellular Matrix Stability in Transcatheter Heart Valves

Increased TGFβ1 and SMAD3 Contribute to Age-Related Aortic Valve Calcification

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