Bioprosthetic Valve Deterioration

• DOI: 10.1016/j.jacbts.2023.01.003
• Publication Date: 2023-05-10T18:39:01Z
• Authors: Tomohisa Sakaue; Tadaaki Koyama; Yoshitsugu Nakamura; Keitaro Okamoto; Takayuki Kawashima; Tadashi Umeno; Yasuhide Nakayama; Shinji Miyamoto; Fumiaki Shikata; Mika Hamaguchi; Jun Aono; Mie Kurata; Kenji Namiguchi; Shunji Uchita; Junya Masumoto; Osamu Yamaguchi; Shigeki Higashiyama; Hironori Izutani
• Keywords: Infiltration (HVAC); Histology; Cellular infiltration

Histologic evaluations revealed excessive accumulations of macrophages and absence fibroblastic interstitial cells in explanted bioprosthetic valves. Comprehensive gene protein expression analysis histology unveiled an accumulation fibrinogen plasminogen, activator infiltrated macrophages, from degenerated valve surfaces the spaces. These pathologies were completely reproduced a goat model replaced with autologous pericardium-derived aortic valve. Further preclinical animal experiments using goats demonstrated that preventing infiltration circulating proteins by increasing collagen density leaflet strength is effective treatment option.