Abstract
Transcatheter aortic valve implantation (TAVI) has received much attention and development in the past decade due to its lower risk of complication and infections compared to a traditional open thoracotomy. However, the current commercial transcatheter heart valve does not fully meet clinical needs; therefore, new biological materials must be found in order to meet these requirements. We have discovered a new type of biological material, the yak pericardium. This current research studied its extracellular matrix structure, composition, mechanical properties, and amino acid content. Folding experiment was carried out to analyze the structure and mechanics after folding. We also conducted a subcutaneous embedding experiment to analyze the inflammatory response and calcification after implantation. Australian bovine pericardium, local bovine pericardium, and porcine pericardium were used as controls. The overall structure of the yak pericardium is flat, the collagen runs regularly, it has superior mechanical properties, and the average thickness is significantly lower than that of the Australian bovine and the local bovine pericardium control groups. The yak pericardium has a higher content of elastic fibers, showing that it has a better compression resistance effect during the folding experiment as well as having less expression of transplantation-related antigens. We conducted in vivo experiments and found that the yak pericardium has less inflammation and a lower degree of calcification. In summary, the yak pericardium, which is thin and strong, has lower immunogenicity and outstanding anti-calcification effects may be an excellent candidate valve leaflet material for TAVI.
Highlights
Transcatheter heart valve implantation is one of the greatest innovations in treating patients with valvular heart diseases in the 21st century ((Lüscher, 2019))
We explored the pericardial materials crosslinked by glutaraldehyde in order to find more suitable materials for making transcatheter heart valves
The GAG content of the yak pericardium (YP) was similar to Australian bovine pericardium (AP) (p > 0.05), and was significantly lower than local bovine pericardium (LP) (p < 0.001); it was higher than porcine pericardium (PP) (p < 0.001)
Summary
Transcatheter heart valve implantation is one of the greatest innovations in treating patients with valvular heart diseases in the 21st century ((Lüscher, 2019)). The estimated number of potential transcatheter aortic valve implantation (TAVI) candidates was approximately 18,000 in Europe and 90,000 in Northern America ((Durko et al, 2018)). Indicated for elderly patients who are inoperable or are at an extreme risk for conventional surgical valve replacement. TAVI has recently demonstrated non-inferiority for patients at low surgical risk in a short-term follow-up, as well as younger patients with much longer life expectancy In this context, the long-term functionality and durability of bioprosthetic valves for TAVI have gained significant importance ((Fukuhara et al, 2020)). Several notions that are specific to transcatheter valves raise concerns about their durability
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