In Vitro Model for the Evaluation of Innovative Transcatheter Debridement Device (TDD): Pericardium-Based Scaffold and Stem Cells to Reproduce Calcificated Valves

Abstract

Aortic valve stenosis has become the most common valvular disease in elderly patients. Several treatments are available such as surgical aortic valve replacement and transcatheter aortic valve implantation. To date, however, there is a need to discover alternative treatments that can delay the disease progression and, therefore, the implant of a prosthetic valve. In this regard, a decalcification procedure based on the use of ultrasonic waves could represent an innovative solution in transcatheter cardiovascular therapies. In this article, we describe an innovative transcatheter debridement device (TDD) that uses low-intensity ultrasound shock waves for calcium ablation from the native aortic valve and bioprosthetic valve. Mesenchymal stem cells were seeded onto pericardium-based scaffolds and committed into an osteogenic phenotype. After treatment with TDD, cell proliferation was analyzed, as well as lactate dehydrogenase release and cell morphology. The release of calcium and inflammation events were detected. The results confirmed that the TDD was able to induce a safe decalcification without any adverse inflammatory events.

Shockwaves delivery for aortic valve therapy—Realistic perspective for clinical translation?

“…For the whole duration of the procedure, the animals remained with one of the valve leaflets immobilized by the piezoelectric transducer, even if the motion of the other leaflets during the procedure, as well as of the treated leaflet after the procedure were not compromised, suggesting an overall clinical feasibility of the procedure. The biological safety of the procedure was finally confirmed in another report in which the same device was employed to treat an in vitro reconstituted valve tissue, where no major ruptures and no changes in cell viability were observed ( 53 ). At the moment, it is not known whether the delivery of shockwaves to the leaflets results into an induction of inflammation and/or cellular apoptosis ( 54 ) and the permanence of smaller deposits resulting from the fragmentation of the large calcific nodules causes long-term effects on mechanical performance of the valve.…”

Playing with Biophysics: How a Symphony of Different Electromagnetic Fields Acts to Reduce the Inflammation in Diabetic Derived Cells

“…In this view, the control of the ROS production represents a promising strategy to improve wound-healing responses, which involves complex processes consisting of distinct, but overlapping phases, such as hemostasis, inflammation, proliferation and remodeling [ 7 ]. To this aim, several non-invasive technologies have been developed [ 8 , 9 , 10 , 11 , 12 , 13 ]. In literature, it is reported that the exposure to a magnetic field is able to favor the anti-inflammatory molecular pathways and can also decrease the production of the ROS [ 14 ] in many cellular models.…”