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Bioprosthetic heart valves

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https://www.readbyqxmd.com/read/29161994/synthesis-characterization-and-application-of-biodegradable-polymer-grafted-novel-bioprosthetic-tissue
#1
Amrita Pal, Chandrashekhar Pathak, Brent Vernon
Animal tissue has an extended history of clinical use in applications like heart valve bioprosthesis devices, cardiovascular surgical applications etc. but often does not last longer after implantation in the body due to rapid unwanted degradation. The goal of this work is to develop novel composite biomaterials by grafting biological tissue with synthetic, biodegradable polymers. In the current research phase, porcine submucosa, ureter and bovine pericardial tissue are grafted with poly DL-lactide (PLA), poly glycolide (PGA) and poly DL-lactide glycolide (PLGA) copolymers...
November 22, 2017: Journal of Biomaterials Science. Polymer Edition
https://www.readbyqxmd.com/read/29158054/early-outcomes-for-valve-in-valve-tavr-in-degenerative-freestyle-bioprostheses
#2
Stephane Leung Wai Sang, Tyler Beute, John Heiser, Duane Berkompas, Justin Fanning, William Merhi
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is used increasingly to treat bioprosthetic valve failure. A paucity of data exists regarding valve-in-valve (ViV) TAVR in degenerated Freestyle stentless bioprostheses (FSB). This study sought to evaluate the feasibility and short-term outcomes of ViV TAVR in previously placed FSB. METHODS: From October 2014 to September 2016, 22 patients underwent ViV TAVR with a self-expanding transcatheter valve for a failing FSB at a single institution...
November 17, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29129879/transcatheter-aortic-valve-implantation-for-degenerated-19-mm-aortic-bioprosthetic-valve
#3
Kizuku Yamashita, Tomoyuki Fujita, Satsuki Fukushima, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Naonori Kawamoto, Tatsuro Hitsumoto, Nobuyasu Ito, Yasuhiro Hamatani, Atsushi Okada, Hiroyuki Takahama, Makoto Amaki, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Toshihisa Anzai, Satoshi Yasuda, Junjiro Kobayashi
BACKGROUND: The valve-in-valve procedure, in which a transcatheter heart valve (THV) is implanted over a prosthetic valve, has been shown to be safe and therapeutically effective, depending on the size of the replacement valve.Methods and Results:We report 3 cases of successful valve-in-valve procedure to replace a degenerated 19-mm stented prosthetic aortic valve. Balloon-expanding THVs were implanted: 20-mm in the 1st case and 23-mm in the next 2. Aortic stenosis was almost completely resolved in all patients, who recovered promptly and without cardiac adverse events...
November 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29119728/a-framework-for-designing-patient-specific-bioprosthetic-heart-valves-using-immersogeometric-fluid-structure-interaction-analysis
#4
Fei Xu, Simone Morganti, Rana Zakerzadeh, David Kamensky, Ferdinando Auricchio, Alessandro Reali, Thomas J R Hughes, Michael S Sacks, Ming-Chen Hsu
Numerous studies have suggested that medical image derived computational mechanics models could be developed to reduce mortality and morbidity due to cardiovascular diseases by allowing for patient-specific surgical planning and customized medical device design. In this work, we present a novel framework for designing prosthetic heart valves using a parametric design platform and immersogeometric fluid-structure interaction (FSI) analysis. We parameterize the leaflet geometry using several key design parameters...
November 9, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29118948/transcatheter-heart-valve-in-valve-implantation-with-edwards-sapien-bioprosthetic-valve-for-different-degenerated-bioprosthetic-valve-positions-first-iranian-viv-report-with-mid-term-follow-up
#5
Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29100642/medium-term-outcomes-after-implantation-of-expanded-polytetrafluoroethylene-valved-conduit
#6
Yoshio Ootaki, Allison S Welch, Michael J Walsh, Michael D Quartermain, Derek A Williams, Ross M Ungerleider
BACKGROUND: Pulmonary valve replacement is becoming the most frequent congenital heart surgery performed on adolescents and young adults. Numerous surgical options are available, including autologous pericardium, mechanical valves, allografts, and bioprosthetic valves. Each option has limitations with durability and freedom from reintervention for stenosis or insufficiency, particularly in the pediatric population. The purpose of this study was to analyze our uniquely designed, expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) for right ventricular outflow tract reconstruction...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29096125/biaxial-mechanical-behavior-of-bovine-saphenous-venous-valve-leaflets
#7
Jiaqi Lu, Hsiao-Ying Shadow Huang
Chronic venous disease is caused by chronic venous insufficiency (CVI), which results in significant symptoms such as venous ulcers, ankle eczema, leg swelling, etc. Venous valve incompetence is a major cause of CVI. When the valves of veins in the leg become incompetent (i.e., do not close properly), blood is able to flow backwards (i.e., reflux), which results in blood pooling in the lower extremities, distal venous hypertension, and CVI. Current clinical therapies, such as surgical venous valve reconstruction and bioprosthetic venous valve replacement, are highly invasive and only moderately successful...
October 24, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29062752/technical-pitfalls-and-tips-for-the-valve-in-valve-procedure
#8
REVIEW
Vinayak Bapat
Transcatheter aortic valve implantation (TAVI) has emerged as a viable treatment modality for patients with severe aortic valve stenosis and multiple co-morbidities. More recent indications include the use of transcatheter heart valves (THV) to treat degenerated bioprosthetic surgical heart valves (SHV), which are failing due to stenosis or regurgitation. Valve-in-valve (VIV) procedures in the aortic position have been performed with a variety of THV devices, although the balloon-expandable SAPIEN valve platform (Edwards Lifesciences Ltd, Irvine, CA, USA) and self-expandable CoreValve platform (Medtronic Inc...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29057501/different-approaches-to-heart-valve-decellularization-a-comprehensive-overview-of-the-past-30%C3%A2-years
#9
REVIEW
Filippo Naso, Alessandro Gandaglia
Xenogeneic decellularized heart valve scaffolds have the potential to overcome the limitations of existing bioprosthetic heart valves that have limited duration due to calcification and tissue degeneration phenomena. This article presents a review of 30 years of decellularization approaches adopted in cardiovascular tissue engineering, with a focus on the use, either individually or in combination, of different detergents. The safety and efficacy of cell-removal procedures are specifically reported and discussed, as well as the structure and biomechanics of the treated extracellular matrix (ECM)...
October 22, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/29053434/alpha-gal-inactivated-heart-valve-bioprostheses-exhibit-an-anti-calcification-propensity-similar-to-knockout-tissues
#10
Filippo Naso, Ugo Stefanelli, Edward Buratto, Giovanna Lazzari, Andrea Perota, Cesare Galli, Alessandro Gandaglia
BACKGROUND: Glutaraldehyde (GLA) has been used to crosslink bioprosthetic heart valve (BHVs) tissues to enhance their stability, besides ensuring a satisfactory degree of immunological tolerance. Unfortunately, GLA fixation does not guarantee a complete tissue biocompatibility of BHVs in currently used devices. The interaction between preformed human anti-alpha-Gal antibody and alpha-Gal antigens promotes the calcification of GLA-treated alpha-Gal-positive tissue. Recently, an alarming correlation between the presence of the alpha-Gal epitope and a premature BHVs degeneracy was reported...
October 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29031049/heart-valve-scaffold-fabrication-bioinspired-control-of-macro-scale-morphology-mechanics-and-micro-structure
#11
Antonio D'Amore, Samuel K Luketich, Giuseppe M Raffa, Salim Olia, Giorgio Menallo, Antonino Mazzola, Flavio D'Accardi, Tamir Grunberg, Xinzhu Gu, Michele Pilato, Marina V Kameneva, Vinay Badhwar, William R Wagner
Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial...
October 6, 2017: Biomaterials
https://www.readbyqxmd.com/read/29029949/mitral-valve-replacement-using-carpentier-edwards-pericardial-bioprosthesis-in-patients-with-rheumatic-heart-disease-aged-below-40-years-17-year-results
#12
Ujjwal Kumar Chowdhury, Adil Rizvi, Rajeev Narang, Sandeep Seth, Mani Kalaivani, Suruchi Hasija, Lakshmi Kumari
BACKGROUND: This study was designed to evaluate patients aged less than 40 years implanted with tissue heart valves with respect to survival, thromboembolism, structural degeneration and quality of life. METHODS: Between January, 2000 and December, 2016, 132 patients (51 males) with rheumatic heart disease underwent mitral valve replacement using Carpentier-Edwards, perimount, pericardial bioprostheses. The patients' ages ranged between 12 and 39 years (mean±SD 30...
August 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28982556/early-outcomes-of-percutaneous-transvenous-transseptal-transcatheter-valve-implantation-in-failed-bioprosthetic-mitral-valves-ring-annuloplasty-and%C3%A2-severe-mitral-annular-calcification
#13
Mackram F Eleid, Brian K Whisenant, Allison K Cabalka, Mathew R Williams, Mohammed Nejjari, David Attias, Neil Fam, Nicholas Amoroso, Thomas A Foley, Peter M Pollak, Oluseun O Alli, Sorin V Pislaru, Sameh M Said, Joseph A Dearani, Charanjit S Rihal
OBJECTIVES: The aim of this study was to examine 1-year outcomes of transseptal balloon-expandable transcatheter heart valve implantation in failed mitral bioprosthesis, ring annuloplasty, and mitral annular calcification (MAC). BACKGROUND: Immediate outcomes following transseptal mitral valve implantation in failed bioprostheses are favorable, but data on subsequent outcomes are lacking. METHODS: Percutaneous transseptal implantation of balloon-expandable transcatheter heart valves was performed in 87 patients with degenerated mitral bioprostheses (valve in valve [VIV]) (n = 60), previous ring annuloplasty (valve in ring) (n = 15), and severe MAC (valve in MAC) (n = 12)...
October 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28980492/computational-methods-for-the-aortic-heart-valve-and-its-replacements
#14
Rana Zakerzadeh, Ming-Chen Hsu, Michael S Sacks
Replacement with a prosthetic device remains a major treatment option for the patients suffering from heart valve disease, with prevalence growing resulting from an ageing population. While the most popular replacement heart valve continues to be the bioprosthetic heart valve (BHV), its durability remains limited. There is thus a continued need to develop a general understanding of the underlying mechanisms limiting BHV durability to facilitate development of a more durable prosthesis. In this regard, computational models can play a pivotal role as they can evaluate our understanding of the underlying mechanisms and be used to optimize designs that may not always be intuitive...
October 23, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28939354/a-deep-learning-approach-to-estimate-chemically-treated-collagenous-tissue-nonlinear-anisotropic-stress-strain-responses-from-microscopy-images
#15
Liang Liang, Minliang Liu, Wei Sun
Biological collagenous tissues comprised of networks of collagen fibers are suitable for a broad spectrum of medical applications owing to their attractive mechanical properties. In this study, we developed a noninvasive approach to estimate collagenous tissue elastic properties directly from microscopy images using Machine Learning (ML) techniques. Glutaraldehyde-treated bovine pericardium (GLBP) tissue, widely used in the fabrication of bioprosthetic heart valves and vascular patches, was chosen to develop a representative application...
November 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28935328/valve-in-valve-transcatheter-aortic-valve-implantation-a-novel-approach-to-treat-paravalvular-leak
#16
Pranav Loyalka, Kelsey B Montgomery, Tom C Nguyen, Richard W Smalling, Melissa Howe, Keshava Rajagopal
Enlarging or "cracking" a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28917497/comparison-of-outcome-of-possible-versus-definite-infective-endocarditis-involving-prosthetic-or-bioprosthetic-heart-valves
#17
MULTICENTER STUDY
Laurent Fauchier, Lauriane Pericart, Thierry Bourguignon, Thibaud Genet, Arnaud Bisson, Anne Bernard, Louis Bernard, Dominique Babuty
The objectives of this study were to describe and compare the clinical characteristics and outcomes of patients with definite and possible infective endocarditis (IE) involving prosthetic heart valve, and to identify prognostic factors for long-term mortality, using data from an unselected cohort of consecutive patients. We studied data from 133 consecutive patients with IE involving prosthetic heart valve seen in an academic institution between 1990 and 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 47, 35%) and patients with definite IE (n = 86, 65%)...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28915471/characterization-of-mechanical-properties-of-pericardium-tissue-using-planar-biaxial-tension-and-flexural-deformation
#18
Kyle Murdock, Caitlin Martin, Wei Sun
Flexure is an important mode of deformation for native and bioprosthetic heart valves. However, mechanical characterization of bioprosthetic leaflet materials has been done primarily through planar tensile testing. In this study, an integrated experimental and computational cantilever beam bending test was performed to characterize the flexural properties of glutaraldehyde-treated bovine and porcine pericardium of different thicknesses. A strain-invariant based structural constitutive model was used to model the pericardial mechanical behavior quantified through the bending tests of this study and the planar biaxial tests previously performed...
January 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28913586/evolving-indications-for-transcatheter-aortic-valve-interventions
#19
REVIEW
Anna Franzone, Thomas Pilgrim, Stefan Stortecky, Stephan Windecker
PURPOSE OF REVIEW: The purpose of this review was to summarize recent progress in the field of transcatheter aortic valve replacement (TAVR), discuss expansion of indications, and identify areas of future clinical applications. RECENT FINDINGS: Favorable clinical outcomes as well as continued refinement of transcatheter heart valve technology have prompted the continuous expansion of indications for TAVR. The results of randomized clinical trials comparing the safety and efficacy of TAVR relative to conventional surgical aortic valve replacement (SAVR) in lower- than high-risk patients have recently been published, and trials among lower-risk categories are ongoing...
September 14, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28894058/-ruptured-aneurysm-of-the-sinus-of-valsalva-accompanied-with-a-bicuspid-aortic-valve-in-an-elderly-man-report-of-a-case
#20
Toshifumi Murase, Susumu Tamura, Yasuhiro Ohzeki, Kunio Ebine
The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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