Artificial Heart Valves with Balanced Charged Networks Exhibiting Anti-Calcification Properties

Currently, the only treatment for moderate and severe aortic valve calcification disease is valve replacement. The clinical use of bioprosthetic heart valves (BHVs) is limited because of device failure caused by structural degeneration, such as the calcification of BHV leaflets. In the present study, poly(ethylene glycol) diacrylate (PEGDA) was incorporated with zwitterion (2-[methacryloyloxy]ethyl)dimethyl-(3-sulfopropyl) ammonium hydroxide (SBMA) forming a balanced charged network, which was further used to modify decellularized heart valves (DHV) and improve anticalcification properties. Valvular prostheses were designed and manufactured to comply with the requirements of ISO-5840 for valve fluid dynamics (i.e., effective orifice area = 1.9 cm², regurgitant fraction = 1.5% for Φ25 mm surgical valve at heart stroke of 80 mL). Weight loss of artificial heart valves (PEGDA-SBMA-DHV) was less than 5.5% after enzymatic hydrolysis for 12 h. No obvious calcification was observed in artificial heart valves that were modified with PEGDA-SBMA, whereas calcification was found in decellularized heart valves and the PEGDA-modified group. Furthermore, histological staining results indicated that artificial heart valves (PEGDA-SBMA-DHV) with a balanced charged network elicited negligible inflammation. Thus, balanced charged networks of PEGDA-SBMA with cationic and anionic groups can prevent the transportation of Ca²⁺ ions and enzyme molecules, conferring efficient anticalcification properties to artificial heart valves.