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Prevention of bioprosthetic heart valve calcification: strategies and outcomes

L P Bre, R McCarthy, W Wang1

  • 1Network of Excellence for Functional Biomaterials (NFB), National University of Ireland, Galway, IDA Business Park, Dangan, Galway, Ireland. wenxin.wang@ucd.ie.

Current Medicinal Chemistry
|December 24, 2013
PubMed

Insights

Bioprosthetic heart valves face calcification, limiting their use. Researchers are exploring new treatments to improve durability and reduce mineralization, aiming for longer-lasting valve replacements without lifelong anticoagulation.

Area of Science:

  • Biomaterials Science
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Heart valve replacement presents a choice between mechanical valves (durable but requiring anticoagulation) and bioprosthetic valves (better hemodynamics but limited durability due to calcification).
  • Early onset calcification is the primary cause of bioprosthetic valve failure, restricting their use mainly to elderly patients.

Purpose of the Study:

  • To review the pathophysiology of tissue valve calcification.
  • To focus on strategies developed to prevent bioprosthetic heart valve calcification.
  • To discuss the outcomes and clinical translation of these prevention strategies.

Main Methods:

  • Review of existing literature on tissue valve calcification.
  • Analysis of factors influencing bioprosthetic valve mineralization (patient age, fixatives, phospholipids, cell debris, mechanical stress).
  • Examination of various calcification reduction strategies, including new fixatives and post-treatments.

Main Results:

  • Identified key factors contributing to tissue mineralization in bioprosthetic valves.
  • Highlighted diverse approaches being developed to inhibit calcification.
  • Assessed the general outcomes and clinical applicability of these novel strategies.

Conclusions:

  • Preventing bioprosthetic heart valve calcification is crucial for improving long-term outcomes.
  • Ongoing research into novel fixatives and processing techniques shows promise for enhancing valve durability.
  • Successful translation of these strategies could expand the use of bioprosthetic valves to younger patients, avoiding lifelong anticoagulation.

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