Key result
Hydrogel hybrid porcine pericardium recovered quickly after 10 days of folding and demonstrated improved biocompatibility and reduced immune response compared to traditional GLU-treated valves.
Why the study?
Glutaraldehyde-treated TAVI leaflets fail to unfold properly after long-term crimping for pre-mounted dry systems and exhibit cytotoxicity and immune responses.
Does hydrogel hybrid porcine pericardium improve unfolding properties and biocompatibility compared to traditional glutaraldehyde-treated pericardium for TAVI valves?
Does hydrogel hybrid porcine pericardium improve unfolding properties and biocompatibility compared to traditional glutaraldehyde-treated pericardium for TAVI valves?
MPC hydrogel hybridization of porcine pericardium improves unfolding properties and biocompatibility, offering a promising material strategy for pre-mounted TAVI valves.
Should not yet change TAVI valve practice; leaves open translation of hybrid pericardium benefits to human implants.
Transcatheter aortic valve implantation (TAVI) has been developed years ago for patients who cannot undergo a surgical aortic valve replacement (SAVR). Although TAVI possesses the advantages of lower trauma and simpler manipulation compared to SAVR, the need for storage in glutaraldehyde (GLU) and a tedious intraoperative assembly process have caused great inconvenience for its further application. A pre-mounted TAVI valve assembled by mounting a dry valve frame to a delivery system is expected to address these problems. However, the currently used GLU treated leaflet cannot unfold normally after being crimped for a long-term and loses its function when the BHV is assembled to the catheter. Besides, its cytotoxicity and immune response after implantation are still problems to be solved. In the present study, a hydrogel hybrid porcine pericardium (HHPP) approach was developed to endow the BHVs with a favorable unfolding property and good biocompatibility. Three monomers with different charge characteristics (sodium acrylate, 2-methacryloyloxyethyl phosphorylcholine, and acryloyloxyethyltrimethyl ammonium chloride) were complexed with GLU treated PP (GLU-PP) to form three kinds of HHPPs (SAAH-PP, MPCH-PP, and DACH-PP). The results of the crimping simulation experiment showed that all HHPPs could quickly recover in PBS after being folded for 10 days, while the traditional BHVs (GLU-PP) could not recover under the same conditions. Bovine serum albumin adsorption and platelet adhesion test showed that SAAH-PP and MPCH-PP had good anti-adhesion abilities. A cell culture study indicated that all the three HHPPs promoted HUVEC growth and proliferation. In vivo biocompatibility studies showed that the immune response induced by MPCH-PP was reduced compared to that by GLU-PP. These studies demonstrated that the strategy of MPC hydrogel hybridization may be an effective approach to prepare a pre-mounted TAVI valve with improved biocompatibility.
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Guo et al. (2019) studied Aortic valve disease requiring TAVI. Hydrogel hybrid porcine pericardium (HHPP) vs. Glutaraldehyde treated porcine pericardium (GLU-PP) was evaluated on Unfolding property, biocompatibility, and immune response. Hydrogel hybrid porcine pericardium recovered quickly after 10 days of folding and demonstrated improved biocompatibility and reduced immune response compared to traditional GLU-treated valves.
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