Portal de Periódicos da CAPES

Bioprosthetic Valve Deterioration

2023; Elsevier BV; Volume: 8; Issue: 7 Linguagem: Inglês

10.1016/j.jacbts.2023.01.003

2452-302X

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,

Orthopaedic implants and arthroplasty

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