Biomaterials in Valvular Heart Diseases

Abstract

Valvular heart disease (VHD) occurs as the result of valvular malfunction, which can greatly reduce patient’s quality of life and if left untreated may lead to death. Different treatment regiments are available for management of this defect, which can be helpful in reducing the symptoms. The global commitment to reduce VHD-related mortality rates has enhanced the need for new therapeutic approaches. During the past decade, development of innovative pharmacological and surgical approaches have dramatically improved the quality of life for VHD patients, yet the search for low cost, more effective, and less invasive approaches is ongoing. The gold standard approach for VHD management is to replace or repair the injured valvular tissue with natural or synthetic biomaterials. Application of these biomaterials for cardiac valve regeneration and repair holds a great promise for treatment of this type of heart disease. The focus of the present review is the current use of different types of biomaterials in treatment of valvular heart diseases.

Aortic valve disease in diabetes: Molecular mechanisms and novel therapies

“…Since heart valve tissues cannot regenerate spontaneously, replacement with artificial biological or mechanical heart valves, repair via reconstructive surgery or interventional catheterization is the current treatment option for management of advanced heart valve diseases. 25 Artificial valves have a limited lifespan of ~10-15 years after implantation due to degeneration, calcification and thrombosis. 80 Moreover, durability of artificial valves is further reduced to only 5-7 years in diabetic patients 81 There is an increased number of aVICs and oVICs and MAC in the valvular stroma.…”

“…Biomechanical stimuli induce phenotypic and gene expression profile changes in valvular cells. The ventricular surface of the aortic cusps is exposed to unidirectional shear stress, while the aortic side is exposed to oscillatory shear stress 25 ; as a consequence, the valvular endothelial cells (VECs) lining the two sides of the leaflets have distinct phenotypes and gene expression profiles.…”

“…In general, stem cell therapy was developed to correct the dysfunctional recruitment and homing of progenitor cells. 25 The most studied sources of stem cells are the endothelial progenitor cells (EPCs) and the adipose‐derived stem cells (ADSCs).…”

“…Overall, TEHVs are still in their infancy period, and the translation to the clinic still faces many challenges. 25 Notably, it is not known what the effect of diabetes would be on implanted TEHV, specifically on the scaffolds or directly on the cells. We have shown earlier that pre‐implantation treatment of the scaffolds with an antioxidant (penta galloyl glucose), a matrix binding polyphenol, reduces aortic valve scaffold biodegradation and calcification, 84 thus opening avenues for development of TEHV resistant to diabetes.…”

Overview on the Antimicrobial Activity and Biocompatibility of Sputtered Carbon-Based Coatings

“…The key issue here is the composition of the implant surface to prevent the formation of thrombi that can lead to coronary heart disease. To assess this property, the adhesion of blood platelets on this surface is usually evaluated, since it is these elements that lead to thrombus formation [71][72][73].…”