Category: General

Front Cardiovasc Med. 2023 Aug 2;10:1213398. doi: 10.3389/fcvm.2023.1213398. eCollection 2023.

ABSTRACT

OBJECTIVE: Bovine pericardium is common biological material for bioprosthetic heart valve. There remains a significant need, however, to improve bioprosthetic valves for longer-term outcomes. This study aims to evaluate the chronic performance of bovine pulmonary visceral pleura (PVP) as bioprosthetic valve cusps.

METHODS: The PVP was extracted from the bovine lung and fixed in 0.625% glutaraldehyde overnight at room temperature. The PVP valve cusps for the bioprosthetic valve were tailored using a laser cutter. Three leaflets were sewn onto a nitinol stent. Six PVP bioprosthetic valves were loaded into the test chamber of the heart valve tester to complete 100 million cycles. Six other PVP bioprosthetic valves were transcardially implanted to replace pulmonary artery valve of six pigs. Fluoroscopy and intracardiac echocardiography were used for in vivo assessments. Thrombosis, calcification, inflammation, and fibrosis were evaluated in the terminal study. Histologic analyses were used for evaluations of any degradation or calcification.

RESULTS: All PVP bioprosthetic valves completed 100 million cycles without significant damage or tears. In vivo assessments showed bioprosthetic valve cusps open and coaptation at four months post-implant. No calcification and thrombotic deposits, inflammation, and fibrosis were observed in the heart or pulmonary artery. The histologic analyses showed complete and compact elastin and collagen fibers in the PVP valve cusps. Calcification-specific stains showed no calcific deposit in the PVP valve cusps.

CONCLUSIONS: The accelerated wear test demonstrates suitable mechanical strength of PVP cusps for heart valve. The swine model demonstrates that the PVP valve cusps are promising for valve replacement.

PMID:37600031 | PMC:PMC10433919 | DOI:10.3389/fcvm.2023.1213398

Cureus. 2023 Jun 16;15(6):e40497. doi: 10.7759/cureus.40497. eCollection 2023 Jun.

ABSTRACT

Tricuspid regurgitation (TR) is an important but underappreciated disease in medical practice, and the severity can vary from moderate to severe. Right-sided infective endocarditis (RSIE) is more common in intravenous drug users (IVDUs), and the vast majority of these involve the tricuspid valve (TV). It is worth mentioning that right-sided valves are challenging to scan compared to left-sided valves. The incidence of severe tricuspid regurgitation (TR) immediately post-repair is not tangible, but it is considered to be rare. We present a case of a 47-year-old patient who had previous TV septal leaflet reconstruction using a bovine pericardial patch using 6/0 prolene, and an annuloplasty was performed by placing an annuloplasty ring in 2017 for infective endocarditis. The patient developed moderate to severe tricuspid regurgitation within a few weeks following the surgery. She was readmitted to the hospital four years later with a reduced consciousness level, and a subsequent repeat echocardiogram showed possible tricuspid valve vegetation. In addition, transoesophageal echocardiogram (TOE) demonstrated biventricular dysfunction and severe tricuspid regurgitation, along with moderate to severe mitral regurgitation (MR) that was variable depending on the rate of atrial fibrillation. The patient was not suitable for surgical intervention and was medically managed accordingly.

PMID:37469811 | PMC:PMC10352586 | DOI:10.7759/cureus.40497

Int J Biol Macromol. 2023 Oct 1;250:126244. doi: 10.1016/j.ijbiomac.2023.126244. Epub 2023 Aug 8.

ABSTRACT

In recent years, bioprosthetic heart valves (BHVs) prepared by cross-linking porcine or bovine pericardium with glutaraldehyde (Glut) have received widespread attention due to their excellent hemocompatibility and hydrodynamic properties. However, the failure of BHVs induced by thrombosis and difficulty in endothelialization still exists in clinical practice. Improving the biocompatibility and endothelialization potential of BHVs is conducive to promoting their anti-thrombosis properties and prolonging their service life. Herein, Cysteine-Alanine-Glycine (CAG) peptide was introduced into the biomimetic BHV materials modified by 2-methacryloyloxyethyl phosphorylcholine (MPC) to improve their anti-thrombosis and promoting-endothelialization performances. MPC can improve the anti-adsorption performance of BHV materials, as well as, CAG contributes to the adhesion and proliferation of endothelial cells on the surface of BHV materials. The results of experiments showed that the biomimetic modification strategy with MPC and CAG reduce the thrombosis of BHV materials and improve their endothelialization in vitro. More importantly, the calcification of BHV significantly reduced by inhibiting the expression of M1 macrophage-related factors (IL-6, iNOS) and promoting the expression of M2 macrophage-related factors (IL-10, CD206). We believe that the valve-modified strategy is expected to provide effective solutions to clinical valve problems.

PMID:37562473 | DOI:10.1016/j.ijbiomac.2023.126244