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Cardiovascular implant calcification: a survey and update
R J Levy1, F J Schoen, H C Anderson
1Department of Pediatrics, University of Michigan, Ann Arbor 49109.
Insights
Cardiovascular prosthetic implants often calcify, affecting devices like bioprosthetic heart valves. Research is exploring biomaterial modifications and drug therapies to prevent this common issue in medical implants.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Biomaterials Science
Background:
- Calcification of cardiovascular prosthetic implants is a significant clinical challenge.
- This issue affects various devices, including bioprosthetic heart valves, aortic homografts, and artificial heart components.
- The precise pathophysiology of implant calcification remains incompletely understood.
Purpose of the Study:
- To provide an updated review on cardiovascular implant calcification.
- To highlight commonalities in the calcification process across different prosthetic types.
- To discuss ongoing research into prevention strategies.
Main Methods:
- Review of findings presented at the 13th World Congress of the International Society for Heart Research (1989).
- Analysis of clinical observations and experimental studies on calcified cardiovascular devices.
- Identification of common pathological elements in calcification.
Main Results:
- Calcific deposits consistently localize to devitalized cells and membranous debris in affected implants.
- Both clinically used prostheses and experimental artificial heart devices show calcification.
- A variety of cardiovascular prostheses are susceptible to calcification.
Conclusions:
- Understanding the localization of calcific deposits is key to understanding implant calcification.
- Prevention strategies, including biomaterial modification and controlled drug release, are under investigation.
- Further research is needed to fully elucidate and prevent cardiovascular implant calcification.
Abstract:
Calcification of cardiovascular prosthetic implants is a common and important problem. This review provides an update based upon the Conference on Cardiovascular Implant Calcification held as part of the 13th World Congress of the International Society for Heart Research, 1989. A variety of cardiovascular prostheses are affected clinically by calcification, including bioprosthetic heart valves, aortic homografts and trileaflet polymeric valve prostheses. In addition, experimental studies have demonstrated calcification of artificial heart devices in ventricular assist systems in long-term calf studies. The pathophysiology of this disease process is incompletely understood. A common element between the various types of cardiovascular implant calcification is the localization of calcific deposits to devitalized cells and membranous debris. Prevention of cardiovascular implant calcification by either biomaterial modifications or regional drug therapy (controlled release) is being investigated.