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In Vitro Calcification of Bioprosthetic Heart Valves: Test Fluid Validation on Prosthetic Material Samples
N Kiesendahl1,2, C Schmitz1,2, M Menne1
1Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute Aachen, RWTH Aachen University, Pauwelsstraße 20, 52074, Aachen, Germany.
Annals of Biomedical Engineering
|September 29, 2020
Summary
Researchers developed a new fluid for faster, more reliable in vitro testing of bioprosthetic heart valve calcification. This method accurately assesses material calcification potential, improving device development.
Area of Science:
- Biomaterials Science
- Cardiovascular Research
- Medical Device Engineering
Background:
- Bioprosthetic heart valve calcification is a primary failure mechanism.
- Current in vitro calcification tests are unreliable due to fluid precipitation issues.
- Accurate and efficient in vitro assessment methods are needed.
Purpose of the Study:
- To develop a near-physiological, non-spontaneously precipitating fluid for accelerated in vitro calcification assessment.
- To validate this fluid by comparing the calcification potential of bovine pericardium and polyurethane materials.
Main Methods:
- Developed a novel fluid for accelerated in vitro calcification testing.
- Compared four calcification fluids using bovine pericardium patches.
- Validated the optimal fluid by testing pericardium against polyurethane.
- Analyzed calcification macroscopically, microscopically, via X-ray diffraction (hydroxyapatite), and von Kossa staining.
Main Results:
- The developed fluid demonstrated a near-physiological, non-spontaneous precipitation behavior.
- Hydroxyapatite, consistent with in vivo findings, was identified as the calcification deposit.
- Both superficial and matrix internal calcifications were observed, influenced by fluid composition.
- The study successfully differentiated calcification potentials between pericardium and polyurethane.
Conclusions:
- The novel fluid shows significant promise for a cost- and time-effective in vitro analysis of bioprosthetic heart valve calcification.
- This method offers improved reliability for assessing material calcification potential.
- Further development could lead to standardized, predictive testing for bioprosthetic heart valves.
