scholarly journals Bioprosthetic Heart Valves: Impact of Implantation on Biomaterials

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Pooja Singhal ◽  
Adriana Luk ◽  
Jagdish Butany
Keyword(s):  
Heart Disease ◽  
Heart Valves ◽  
Prosthetic Heart Valves ◽  
Bioprosthetic Heart Valves ◽  
Modes Of Failure ◽  
Mechanical Valves ◽  
Different Types ◽  
Patient Groups ◽  
Bioprosthetic Valves

Prosthetic heart valves are commonly used in the treatment of valvular heart disease. Mechanical valves are more durable than the bioprosthetic valves; however, the need for long-term anticoagulant therapy renders them unsuitable for some patient groups. In this paper we discuss the different types and models of bioprosthesis, and in particular, pericardial bioprosthesis. We also discuss the preimplantation preparation processes, as well as their postimplantation changes and modes of failure.

scholarly journals Noncalcific Mechanisms of Bioprosthetic Structural Valve Degeneration

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Matteo Marro ◽  
Alexander P. Kossar ◽  
Yingfei Xue ◽  
Antonio Frasca ◽  
Robert J. Levy ◽  
...  
Keyword(s):  
Mechanical Stress ◽  
Heart Valves ◽  
Bioprosthetic Heart Valves ◽  
Mechanical Valves ◽  
Reoperation Rates

Abstract Bioprosthetic heart valves (BHVs) largely circumvent the need for long‐term anticoagulation compared with mechanical valves but are increasingly susceptible to deterioration and reduced durability with reoperation rates of ≈10% and 30% at 10 and 15 years, respectively. Structural valve degeneration is a common, unpreventable, and untreatable consequence of BHV implantation and is frequently characterized by leaflet calcification. However, 25% of BHV reoperations attributed to structural valve degeneration occur with minimal leaflet mineralization. This review discusses the noncalcific mechanisms of BHV structural valve degeneration, highlighting the putative roles and pathophysiological relationships between protein infiltration, glycation, oxidative and mechanical stress, and inflammation and the structural consequences for surgical and transcatheter BHVs.

Early Degeneration of Aortic Bioprosthetic Valves Chemical interactions, prevention and treatment

2019 ◽  
Vol 69 (12) ◽  
pp. 3513-3516
Author(s):  
Andra Oancea ◽  
Maria Luiza Cobzeanu ◽  
Andrei Tarus ◽  
Mihail Enache ◽  
Lacramioara Perianu
Keyword(s):  
Heart Valves ◽  
Mechanical Valve ◽  
Bioprosthetic Valve ◽  
Alcohol Ethoxylate ◽  
Bioprosthetic Heart Valves ◽  
Tissue Degeneration ◽  
Mechanical Valves ◽  
Risk Patients ◽  
Bioprosthetic Valves

Bioprosthetic heart valves ensure a better quality of life compared to mechanical valves but are prone to degeneration with leaflet calcification and tearing. Valvular leaflets mineralization process is initiated within interstitial cells devitalized by glutaraldehyde with formation of calcium phosphate hydroxyapatite crystals. The aim of the current paper is to analyse early bioprosthetic valve degeneration occurring in three patients that needed bioprosthetic valve explantation and reimplantation of a mechanical valve. The three patients, aged 29, 64 and 78 years presented early degeneration of the implanted valve at 30, 36 and 52 months after the intervention in the context of unavoidable risk factors like young age, chronic kidney disease and small stented valve. Computed tomography examination demonstrated calcifications of the bioprosthetic valve and histological examination confirmed the findings by identifying tissue degeneration with calcification in all cases. Early bioprosthetic valve degeneration is a serious issue in cardiovascular surgery and a major cause of valve failure requiring reintervention. Several methods could be used to delay degeneration like systemic therapy with general anti-calcification agents, the use of locally delivered drugs or tissue pretreatment with special substances (ethanol, nonionic detergents, tridecyl alcohol ethoxylate). No optimal decellularization method for all types of tissues has been yet discovered. In conclusion, early bioprosthetic valve degeneration is a reality that should be taken into account in high risk patients. Current tissue pretreatment with glutaraldehyde is not perfect as it accelerates degeneration with formation of hydroxyapatite calcifications. New methods are needed to achieve efficient decellularization while preserving the functional characteristics of the transplanted tissue.

Long-Term Follow-Up and Dobutamine Stress Echocardiography of 19-mm Prosthetic Heart Valves

1998 ◽  
Vol 15 (7) ◽  
pp. 617-624 ◽  
Author(s):  
PATRICK R. HUNZIKER ◽  
BERNHARD SPÖNDLIN ◽  
STEPHAN HEDIGER ◽  
DIETER BURCKHARDT ◽  
WOLFGANG BRETT ◽  
...  
Keyword(s):  
Stress Echocardiography ◽  
Heart Valves ◽  
Dobutamine Stress Echocardiography ◽  
Dobutamine Stress ◽  
Prosthetic Heart Valves ◽  
Long Term Follow Up

scholarly journals Heart failure requiring hospitalization in patients after cardiac surgery for valvular heart disease

2019 ◽  
Vol 26 (2) ◽  
pp. 57-62
Author(s):  
A. V. Zhadan
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Reverse Remodeling ◽  
Damage Indicators ◽  
Heart Pathology ◽  
Permanent Form

The aim – to determine the factors associated with the frequency of hospitalizations for decompensation of heart failure (HF) after cardiac surgery in patients with valvular heart disease. Materials and methods. 235 patients who underwent cardiac surgery for valvular heart disease were examined. During the period from 2014 to 2017, a part of patients (129 people) had no hospitalizations, while 106 people were on inpatient treatment from 1 to 10 times, on average 2.78±1.95. The complex of examination of patients along with physical examination included electrocardiography, echocardiography. Results and discussion. During dynamic observation for 2 years in the group of patients without hospitalization, a progressive statistically significant decrease in the size of the left atrium (LA) and left ventricle (LV) as well as an increase in LV contractility were noted, while in the group of patients after hospitalization such changes were not observed. The dimensions of the chambers of the heart remained practically unchanged for 2 years. Thus, it can be concluded that the more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers. Predictors of hospitalizations for HF are the presence of diabetes mellitus, hypertension and permanent form of atrial fibrillation. Conclusions. The probability of progression of heart failure in patients after cardiosurgical intervention for valvular heart pathology is not affected by sex, age, type of lesion of the valve, etiology of valve damage, indicators of echocardiography. Predictors of hospitalizations for heart faiure in the long-term postoperative period are the presence of diabetes, AF, and AH. The more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers.

Prevalence of microembolic signals in patients with different types of mono-leaflet and bi-leaflet prosthetic heart valves

1998 ◽  
Vol 19 (5) ◽  
pp. 311-314
Author(s):  
M. Del Sette ◽  
S. Angeli ◽  
L. Badano ◽  
M. Caudullo ◽  
G. Bellagamba ◽  
...  
Keyword(s):  
Heart Valves ◽  
Prosthetic Heart Valves ◽  
Different Types

A SWINE MODEL FOR LONG-TERM EVALUATION OF PROSTHETIC HEART VALVES

2007 ◽  
Vol 77 (8) ◽  
pp. 654-658 ◽  
Author(s):  
Demin Li ◽  
Bin-Hui Ren ◽  
Yi Shen ◽  
Haiwei Wu ◽  
Changtian Wang ◽  
...  
Keyword(s):  
Heart Valves ◽  
Swine Model ◽  
Prosthetic Heart Valves ◽  
Term Evaluation

Modeling of Tissue Fatigue Damage in Bio-Prosthetic Heart Valve

2011 ◽  
Author(s):  
Caitlin Martin ◽  
Wei Sun
Keyword(s):  
Fatigue Damage ◽  
Heart Valve ◽  
Anticoagulant Therapy ◽  
Heart Valves ◽  
Prosthetic Heart Valve ◽  
Bovine Pericardium ◽  
Prosthetic Heart Valves ◽  
Mechanical Valves ◽  
In Vivo Degradation

Bio-prosthetic heart valves (BHVs) with leaflets made of glutaraldehyde-treated bovine pericardium (GLBP), have been used extensively to replace diseased heart valves. BHVs display superior hemodynamics to mechanical valves and eliminate the need for anticoagulant therapy; however, they exhibit poor durability resulting from in vivo degradation and fatigue damage of the leaflets.

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