Preventing extrinsic mechanisms of bioprosthetic degeneration using polyphenols
Objectives: the purpose of this study was to evaluate the impact of a polyphenols-based treatment on the extrinsic mechanisms responsible for early BHV degeneration. Structural degeneration can be driven by both extrinsic and intrinsic mechanisms. While intrinsic mechanisms have been associated with inherent biocompatibility characteristics of the BHV, the extrinsic ones have been reported to involve external causes, such as chemical, mechanical and hydrodynamic, responsible to facilitate graft damage.
Methods: the chemical interaction and the stability degree between polyphenols and pericardial tissue were carefully evaluated. The detoxification of glutaraldehyde in commercial BHVs models as well as the protective effect from in-vivo calcification were taken into relevant consideration. Finally, the hydrodynamic and biomechanical features of the polyphenols-treated pericardial tissue were deeply investigated by pulse duplicator and stress-strain analysis.
Results: the study demonstrated the durability of the polyphenols-based treatment on pericardial tissue and the stability of the bound polyphenols. The treatment improves glutaraldehyde stabilization's current degree, demonstrating a surprising in-vivo anti-calcific effect. It is able to make the pericardial tissue more pliable while maintaining the correct hydrodynamic characteristics.
Conclusions: the polyphenols treatment has proved to be a promising approach capable of acting simultaneously on several factors related to the premature degeneration of cardiac valve substitutes by extrinsic mechanisms.
Biocompatibility Innovation Srl
- Mechanical, Electrical and Manufacturing Engineering
Published inEuropean Journal of Cardio-Thoracic Surgery
PublisherOxford University Press
- AM (Accepted Manuscript)
Rights holder© The Authors
Publisher statementThis is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardio-Thoracic Surgery following peer review. The version of record Robert J Melder, Filippo Naso, Francesco Nicotra, Laura Russo, Ivan Vesely, Sugat R Tuladhar, Antonio M Calafiore, Peter Zilla, Alessandro Gandaglia, Sotiris Korossis, Preventing extrinsic mechanisms of bioprosthetic degeneration using polyphenols, European Journal of Cardio-Thoracic Surgery, Volume 63, Issue 4, April 2023, ezac583, https://doi.org/10.1093/ejcts/ezac583 is available online at: https://doi.org/10.1093/ejcts/ezac583.