International Journal of Cardiovascular and Thoracic Surgery

| Peer-Reviewed |

Evolution of Bioprosthetic Valves, Where We Are Heading

Received: 4 September 2023    Accepted: 25 September 2023    Published: 8 October 2023
Views:       Downloads:

Share This Article

Abstract

Bioprosthetic heart valves are made from animal tissue and used to replace damaged or diseased heart valves. The first bioprosthetic valve was implanted in 1960, and since then, there have been significant advances in their design and development. Early valves were made from glutaraldehyde-preserved porcine valves and had a high risk of calcification. In the 1980s, cryopreserved porcine valves were introduced, which are less likely to calcify. Tissue-engineered heart valves, made from cells and tissues grown in the lab, are still in development but have the potential to offer longer lifespans and lower risk of rejection. Continuous research and development are happening to improve design, swing ring, cuff size, ring material, storage solution, rinsing time, anticalcification treatment, ease of implant for surgeons, and making these valves future ready for interventional procedures. Currently we are having fourth generation of these valves (Company classification). The evolution of bioprosthetic heart valves has led to improved outcomes for patients with heart valve disease. These valves are now a standard treatment option and offer a good quality of life and long-term survival. Initial results of both bovine fourth generation bioprosthetic valves Medtronic Avalus (PERIGON trial) and Edwards Inspiris resilia (COMMENCE trial) are good. The evolution of bioprosthetic heart valves is an ongoing process. As new technologies are developed, these valves are likely to become even more durable and effective.

DOI 10.11648/j.ijcts.20230905.11
Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 5, September 2023)
Page(s) 63-66
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Bioprosthetic Valves, Evolution, Bovine, Porcine, COMMENCE Trial, PERIGON Trial

References
[1] Kumar T, Singh A, Thakre S, et al. (July 19, 2023) Scientific Evolution of Artificial Heart Valves: A Narrative Review. Cureus 15 (7): e42131. DOI10.7759/cureus.42131.
[2] Braathen B, Husebye T, Lunde IG, Tønnessen T. Trifecta has lower gradient and less prosthesis–patient mismatch than Mosaic Ultra in the aortic position: a prospective randomized study. J Thorac Cardiovasc Surg 2018; 158: 1032–9.
[3] Vesely I. The evolution of bioprosthetic heart valve design and its impact on durability. Cardiovasc Pathol 2003; 12: 277–86.
[4] Roselli EE. Invited commentary on long-term durability of Carpentier-Edwards Magna Ease valve: a one billion cycle in vitro study. Ann Thorac Surg 2016; 101: 1766–7.
[5] Généreux P, Head SJ, Wood DA, et al. Transcatheter aortic valve implantation: 10-year anniversary part II: clinical implications. Eur Heart J 2012; 33: 2399–402.
[6] Bapat V, Attia R, Redwood S, et al. Use of transcatheter heart valves for a valve-in-valve implantation in patients with degenerated aortic bioprostheses: technical considerations and results. J Thorac CardiovascSurg 2012; 144: 1372–9.
[7] Vriesendorp MD, de Lind van Wijngaarden RAF, Rao V, Moront MG, Patel HJ, Sarnowski E et al. An in vitro comparison of internally versus externally mounted leaflets in surgical aortic bioprostheses. Interact CardioVasc Thorac Surg 2020; 30: 417–23.
[8] Singh SK, Kachel M, Castillero E, Xue Y, Kalfa D, Ferrari G and George I (2023) Polymeric prosthetic heart valves: A review of current technologies and future directions. Front. Cardiovasc. Med.10:1137827. doi: 10.3389/fcvm.2023.1137827.
[9] Cereijo et al.: Is distortion of the bioprosthesis ring a risk factor for early calcification? Journal of Cardiothoracic Surgery 2010; 5: 77.
[10] D. Y. Tam, R. V. Rocha, H. C. Wijeysundera, P. C. Austin, D. Dvir, and S. E. Fremes, “Surgical valve selection in the era of transcatheter aortic valve replacement in the Society of thoracic Surgeons Database,” 0e Journal of 0oracic and Cardiovascular Surgery, vol. 159, no. 2, pp. 416–427, 2020.
[11] Fiegl K, Deutsch MA, Rondak IC, Lange R, Guenzinger R. Matched Comparison of Two Different Biological Prostheses for Complete Supra-annular Aortic Valve Replacement. Thorac Cardiovasc Surg. 2015; 63: 459-66.
[12] Klautz RJM, Kappetein AP, Lange R, Dagenais F, Labrousse L, Bapat V, Moront M, Misfeld M, Zeng C, Sabik Iii JF; PERIGON Investigators. Safety, effectiveness and haemodynamic performance of a new stented aortic valve bioprosthesis. Eur J Cardiothorac Surg. 2017 Sep 1; 52 (3): 425-431. doi: 10.1093/ejcts/ezx066. PMID: 28475690; PMCID: PMC5848807.
[13] Bavaria JE, Griffith B, Heimansohn DA, Rozanski J, Johnston DR, Bartus K, Girardi LN, Beaver T, Takayama H, Mumtaz MA, Rosengart TK, Starnes V, Timek TA, Boateng P, Ryan W, Cornwell LD, Blackstone EH, Borger MA, Pibarot P, Thourani VH, Svensson LG, Puskas JD; COMMENCE Trial Investigators. Five-year Outcomes of the COMMENCE Trial Investigating Aortic Valve Replacement with RESILIA Tissue. Ann Thorac Surg. 2023 Jun; 115 (6): 1429-1436. doi: 10.1016/j.athoracsur.2021.12.058. Epub 2022 Jan 20. PMID: 35065065.
[14] “FDA expands approval for valve-in-valve replacement,” 2015, https://www.acc.org/latest-in-cardiology/articles/2015/03/31/14/14/fda-expands-approval-for-valve-in-valvereplacement.
[15] Tahir AM, Mutlu O, Bensaali F, Ward R, Ghareeb AN, Helmy SMHA, Othman KT, Al-Hashemi MA, Abujalala S, Chowdhury MEH, Alnabti ARDMH, Yalcin HC. Latest Developments in Adapting Deep Learning for Assessing TAVR Procedures and Outcomes. J Clin Med. 2023 Jul 19; 12 (14): 4774. doi: 10.3390/jcm12144774. PMID: 37510889; PMCID: PMC10381346.
Cite This Article
  • APA Style

    Dhanesh Kumar. (2023). Evolution of Bioprosthetic Valves, Where We Are Heading. International Journal of Cardiovascular and Thoracic Surgery, 9(5), 63-66. https://doi.org/10.11648/j.ijcts.20230905.11

    Copy | Download

    ACS Style

    Dhanesh Kumar. Evolution of Bioprosthetic Valves, Where We Are Heading. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(5), 63-66. doi: 10.11648/j.ijcts.20230905.11

    Copy | Download

    AMA Style

    Dhanesh Kumar. Evolution of Bioprosthetic Valves, Where We Are Heading. Int J Cardiovasc Thorac Surg. 2023;9(5):63-66. doi: 10.11648/j.ijcts.20230905.11

    Copy | Download

  • @article{10.11648/j.ijcts.20230905.11,
      author = {Dhanesh Kumar},
      title = {Evolution of Bioprosthetic Valves, Where We Are Heading},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {9},
      number = {5},
      pages = {63-66},
      doi = {10.11648/j.ijcts.20230905.11},
      url = {https://doi.org/10.11648/j.ijcts.20230905.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230905.11},
      abstract = {Bioprosthetic heart valves are made from animal tissue and used to replace damaged or diseased heart valves. The first bioprosthetic valve was implanted in 1960, and since then, there have been significant advances in their design and development. Early valves were made from glutaraldehyde-preserved porcine valves and had a high risk of calcification. In the 1980s, cryopreserved porcine valves were introduced, which are less likely to calcify. Tissue-engineered heart valves, made from cells and tissues grown in the lab, are still in development but have the potential to offer longer lifespans and lower risk of rejection. Continuous research and development are happening to improve design, swing ring, cuff size, ring material, storage solution, rinsing time, anticalcification treatment, ease of implant for surgeons, and making these valves future ready for interventional procedures. Currently we are having fourth generation of these valves (Company classification). The evolution of bioprosthetic heart valves has led to improved outcomes for patients with heart valve disease. These valves are now a standard treatment option and offer a good quality of life and long-term survival. Initial results of both bovine fourth generation bioprosthetic valves Medtronic Avalus (PERIGON trial) and Edwards Inspiris resilia (COMMENCE trial) are good. The evolution of bioprosthetic heart valves is an ongoing process. As new technologies are developed, these valves are likely to become even more durable and effective.},
     year = {2023}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Evolution of Bioprosthetic Valves, Where We Are Heading
    AU  - Dhanesh Kumar
    Y1  - 2023/10/08
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijcts.20230905.11
    DO  - 10.11648/j.ijcts.20230905.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 63
    EP  - 66
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20230905.11
    AB  - Bioprosthetic heart valves are made from animal tissue and used to replace damaged or diseased heart valves. The first bioprosthetic valve was implanted in 1960, and since then, there have been significant advances in their design and development. Early valves were made from glutaraldehyde-preserved porcine valves and had a high risk of calcification. In the 1980s, cryopreserved porcine valves were introduced, which are less likely to calcify. Tissue-engineered heart valves, made from cells and tissues grown in the lab, are still in development but have the potential to offer longer lifespans and lower risk of rejection. Continuous research and development are happening to improve design, swing ring, cuff size, ring material, storage solution, rinsing time, anticalcification treatment, ease of implant for surgeons, and making these valves future ready for interventional procedures. Currently we are having fourth generation of these valves (Company classification). The evolution of bioprosthetic heart valves has led to improved outcomes for patients with heart valve disease. These valves are now a standard treatment option and offer a good quality of life and long-term survival. Initial results of both bovine fourth generation bioprosthetic valves Medtronic Avalus (PERIGON trial) and Edwards Inspiris resilia (COMMENCE trial) are good. The evolution of bioprosthetic heart valves is an ongoing process. As new technologies are developed, these valves are likely to become even more durable and effective.
    VL  - 9
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Cardiothoracic and Vascular Surgery, Medanta-the Medicity, Gurugram, India

  • Sections