Calcification and Thrombosis as Mediators of Bioprosthetic Valve Deterioration

Ramana, Ravi K.; Morreale, Chad; Kothari, Sorabh; Moura, Luís M; Best, Patricia J.M.; Burke, Martin C.; Rajamannan, Nalini M.

doi:10.1080/24748706.2018.1562265

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Heart valve replacement has been regarded as the most effective method for fearful VHD, and the number of procedures is on the rise, with more than 300,000 operations performed per year globally. , The replacement process is very sophisticated after many years of development and perfection, but there are not many valve options available in the market. Although some improvements have been made, the mechanical and bioprosthetic prostheses currently available are still at risk of thrombosis and premature structural destruction. − Calcification is the main reason for the failure of bioprosthetic, which is a complicated problem caused by various biological and physical factors. − It makes the graft more fragile and susceptible to decay. The ideal bioprosthetic valve should have a high mechanical strength and a similar, or better, biocompatibility to that of the native valve.…”

Section: Introductionmentioning

confidence: 99%

Anticalcification Potential of POSS-PEG Hybrid Hydrogel as a Scaffold Material for the Development of Synthetic Heart Valve Leaflets

Guo

Zhou

Liu

et al. 2021

ACS Appl. Bio Mater.

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Calcification of bioprosthetics is a primary challenge in the field of artificial heart valves and a main reason for biological heart valve prostheses failure. Recent advances in nanomaterial science have promoted the development of polymers with advantageous properties that are likely suitable for artificial heart valves. In this work, we developed a nanocomposite polymeric biomaterial POSS–PEG (polyhedral oligomeric silsesquioxane-polyethylene glycol) hybrid hydrogel, which not only has improved mechanical and surface properties but also excellent biocompatibility. The results of atomic force microscopy and in vivo animal experiments indicated that the content of POSS in the PEG matrix plays an important role on the surface and contributes to its biological properties, compared to the decellularized porcine aortic valve scaffold. Additionally, this modification leads to enhanced protection of the hydrogel from thrombosis. Furthermore, the introduction of POSS nanoparticles also gives the hydrogel a better calcification resistance efficacy, which was confirmed through in vitro tests and animal experiments. These findings indicate that POSS–PEG hybrid hydrogel is a potential material for functional heart valve prosthetics, and the use of POSS nanocomposites in artificial valves may offer potential long-term performance and durability advantages.

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Section: Introductionmentioning

confidence: 99%

Anticalcification Potential of POSS-PEG Hybrid Hydrogel as a Scaffold Material for the Development of Synthetic Heart Valve Leaflets

Guo

Zhou

Liu

et al. 2021

ACS Appl. Bio Mater.

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“…Recent studies 1–3 have suggested that the rate of subclinical leaflet thrombosis (SLT) is as high as 13%–38% 4 . SLT is associated with increased risk of transient ischemic attacks and strokes, acute myocardial infarction, and accelerated valve deterioration 5 . Further, if left untreated, SLT can progress to clinical valve thrombosis.…”

Section: Introductionmentioning

confidence: 99%

“…4 SLT is associated with increased risk of transient ischemic attacks and strokes, acute myocardial infarction, and accelerated valve deterioration. 5 Further, if left untreated, SLT can progress to clinical valve thrombosis. While a cardiac computed tomography (CT) scan can detect SLT, predicting which patients will develop SLT is currently not possible.…”

Section: Introductionmentioning

confidence: 99%

A model offluid–structureand biochemical interactions for applications to subclinical leaflet thrombosis

Barrett

Brown

Smith

et al. 2023

Numer Methods Biomed Eng

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Subclinical leaflet thrombosis (SLT) is a potentially serious complication of aortic valve replacement with a bioprosthetic valve in which blood clots form on the replacement valve. SLT is associated with increased risk of transient ischemic attacks and strokes and can progress to clinical leaflet thrombosis. SLT following aortic valve replacement also may be related to subsequent structural valve deterioration, which can impair the durability of the valve replacement. Because of the difficulty in clinical imaging of SLT, models are needed to determine the mechanisms of SLT and could eventually predict which patients will develop SLT. To this end, we develop methods to simulate leaflet thrombosis that combine fluidstructure interaction and a simplified thrombosis model that allows for deposition along the moving leaflets. Additionally, this model can be adapted to model deposition or absorption along other moving boundaries. We present convergence results and quantify the model's ability to realize changes in valve opening and pressures. These new approaches are an important advancement in our tools for modeling thrombosis because they incorporate both adhesion to the surface of the moving leaflets and feedback to the fluid-structure interaction.

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“…Recent studies [25,26,36] have suggested that the rate of subclinical leaflet thrombosis (SLT) is as high as 13-38% [34]. SLT is associated with increased risk of transient ischemic attacks and strokes, acute myocardial infarction, and accelerated valve deterioration [32]. Further, if left untreated, SLT can progress to clinical valve thrombosis.…”

Section: Introductionmentioning

confidence: 99%

A Model of Fluid-Structure and Biochemical Interactions for Applications to Subclinical Leaflet Thrombosis

Barrett¹,

Brown²,

Smith³

et al. 2022

Preprint

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Subclinical leaflet thrombosis (SLT) is a potentially serious complication of aortic valve replacement with a bioprosthetic valve in which blood clots form on the replacement valve. SLT is associated with increased risk of transient ischemic attacks and strokes and can progress to clinical leaflet thrombosis. SLT following aortic valve replacement also may be related to subsequent structural valve deterioration, which can impair the durability of the valve replacement. Because of the difficulty in clinical imaging of SLT, models are needed to determine the mechanisms of SLT and could eventually predict which patients will develop SLT. To this end, we develop methods to simulate leaflet thrombosis that combine fluid-structure interaction and a simplified thrombosis model that allows for deposition along the moving leaflets. Additionally, this model can be adapted to model deposition or absorption along other moving boundaries. We present both convergence results and quantify the model's ability to realize changes in stroke volume and pressures. These new approaches are an important advancement in thrombosis modeling in that it incorporates both adhesion to the surface of the leaflets and feedback to the fluid-structure interaction.

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Calcification and Thrombosis as Mediators of Bioprosthetic Valve Deterioration

Cited by 5 publications

References 27 publications

Anticalcification Potential of POSS-PEG Hybrid Hydrogel as a Scaffold Material for the Development of Synthetic Heart Valve Leaflets

Anticalcification Potential of POSS-PEG Hybrid Hydrogel as a Scaffold Material for the Development of Synthetic Heart Valve Leaflets

A model offluid–structureand biochemical interactions for applications to subclinical leaflet thrombosis

A Model of Fluid-Structure and Biochemical Interactions for Applications to Subclinical Leaflet Thrombosis

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