Development of a next-generation tissue valve using a glutaraldehyde-fixed porcine aortic valve treated with decellularization, α-galactosidase, space filler, organic solvent and detoxification

Lim, Hong Gook; Kim, Jun Seok; Jeong, Saeromi; Kim, Yong Jin

doi:10.1093/ejcts/ezu385

Cited by 31 publications

(34 citation statements)

References 21 publications

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“…We did not find significant differences in the concentration of cytokines in our population according to the type of valve implanted even when the valve prostheses are manufactured with different materials. Biological valvular prostheses are made from animal tissue that is subjected to a decellularization process and glutaraldehyde fixation in order to reduce their immunogenicity [19, 20]. The artificial valves are manufactured from various synthetic materials, including carbon graphite, pyrolytic carbon and titanium [21].…”

Section: Discussionmentioning

confidence: 99%

Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis

Soto

Salas

Vargas-Barrón

et al. 2017

BMC Cardiovasc Disord

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BackgroundThe inflammatory process in aortic valvular stenosis persists after surgery to replace the valve in almost half of the patients. No association has been found to its persistence. The main objective of this study was to evaluate the inflammatory response in patients with aortic stenosis through the determination of several biomarkers in plasma measured before and after the valvular replacement and to seek an association with the type of prosthesis used.MethodsThis is an observational study with a follow up of 6 months in subjects with severe aortic stenosis. Seric concentrations of TNFa, IL-1, IL-6 and ICAM and echocardiographic variables were quantified previous to the surgery and a week and 6 months after it. A group of control subjects paired by age and gender was included.ResultsSeventy-nine subjects were studied of which 57% were male; the average age was of 59 (± 11.4) years. Previous to surgery, the concentration of cytokines was higher in patients than in control subjects. A biological prosthesis was implanted in 48 patients and a mechanical prosthesis in 31. Both, types of prosthesis have components made of titanium. The echocardiograms 1 week and 6 months after the surgery showed a decrease in the mean aortic gradient and an increase in the valvular area (p = 0.001). Half of the patients still showed high proinflammatory cytokine levels. There were no differences according to the type of prosthesis implanted after adjustments for demographic variables, comorbidities and echocardiographic data.ConclusionsThe inflammatory response caused by both types of valvular prothesis at 6 months after implantation were similar. Both types of prosthesis are recommended, they had similarities in hemodynamic profiles registered with Doppler echocardiography. Age of the patient or the suitability use of anticoagulants determines the type of prosthesis to be used.

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Section: Discussionmentioning

confidence: 99%

Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis

Soto

Salas

Vargas-Barrón

et al. 2017

BMC Cardiovasc Disord

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“…(3) Only the very avant-garde centers, such as the Hannover and Seoul Group, are trying to tackle this important question by means of detergent-based decellularization procedures 13,14 or by using alpha-galactosidase. 15 Tissueengineering research is ongoing in most academic centers of relevance, but commercial producers must instigate the manufacture of such ''humanized'' bioprostheses with potentially longer life spans. The first successful endeavors in that direction have been reported.…”

Section: When Meat Allergy Meets Cardiac Surgery: a Driver For Humanimentioning

confidence: 99%

“…13 As a first step, recent studies demonstrated equivalent physical properties of a-gal-deficient pericardium. 14,15 The main benefit to CRISPR is the ability to perform multiple genetic manipulations simply and efficiently. Of course, a-gal is not the only immunogenic carbohydrate antigen present in bioprosthetic heart valves, and the next generation of valves should address them all.…”

Section: Mammalian Meat Allergy and Advances In Bioprosthetic Valve Tmentioning

confidence: 99%

When meat allergy meets cardiac surgery: A driver for humanized bioprosthesis

Ankersmit

Copic

Simader

2017

The Journal of Thoracic and Cardiovascular Surgery

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“…Many researchers decellularize via immersion 47,48 or perfusion 49,50 of the valve, with each methodology adequately removing cellular content. Numerous combinations of detergents and biological agents have been used with varying efficacy, including SDS 47,48,51–53 , trypsin 47,54–56 , EDTA 47,48,53–56 , Triton X-100 47,50–53 , sodium deoxycholate 53,54 , DNase/RNase 47,48 , and hypo/hypertonic solutions 48,50 . Some decellularized valves showed immunogenicity and thrombogenicity 54,55 while other valves did not show any immune response 52,57,58 , the discrepancy of which was dependent on not only the decellularization technique but also postprocessing (e.g.…”

Section: Tissue Engineered Heart Valvesmentioning

confidence: 99%

Current progress in tissue engineering of heart valves: multiscale problems, multiscale solutions

Cheung

Duan

Butcher

2015

Expert Opinion on Biological Therapy

149

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Introduction Heart valve disease is an increasingly prevalent and clinically serious condition. There are no clinically effective biological diagnostics or treatment strategies. The only recourse available is replacement with a prosthetic valve, but the inability of these devices to grow or respond biologically to their environments necessitates multiple resizing surgeries and life-long coagulation treatment, especially in children. Tissue engineering has a unique opportunity to impact heart valve disease by providing a living valve conduit, capable of growth and biological integration. Areas covered This review will cover current tissue engineering strategies in fabricating heart valves and their progress towards the clinic, including molded scaffolds using naturally-derived or synthetic polymers, decellularization, electrospinning, 3D bioprinting, hybrid techniques, and in vivo engineering. Expert opinion While much progress has been made to create functional living heart valves, a clinically viable product is not yet realized. The next leap in engineered living heart valves will require a deeper understanding of how the natural multi-scale structural and biological heterogeneity of the tissue ensures its efficient function. Related, improved fabrication strategies must be developed that can replicate this de novo complexity, which is likely instructive for appropriate cell differentiation and remodeling whether seeded with autologous stem cells in vitro or endogenously recruited cells.

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Development of a next-generation tissue valve using a glutaraldehyde-fixed porcine aortic valve treated with decellularization, α-galactosidase, space filler, organic solvent and detoxification

Cited by 31 publications

References 21 publications

Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis

Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis

When meat allergy meets cardiac surgery: A driver for humanized bioprosthesis

Current progress in tissue engineering of heart valves: multiscale problems, multiscale solutions

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