Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China.
Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, Sichuan, 610041, P. R. China.
Small. 2024 Jun;20(23):e2309844. doi: 10.1002/smll.202309844. Epub 2024 Jan 26.
Valvular heart disease (VHD) has become a burden and a growing public health problem in humans, causing significant morbidity and mortality worldwide. An increasing number of patients with severe VHD need to undergo heart valve replacement surgery, and artificial heart valves are in high demand. However, allogeneic valves from donors are lacking and cannot meet clinical practice needs. A mechanical heart valve can activate the coagulation pathway after contact with blood after implantation in the cardiovascular system, leading to thrombosis. Therefore, bioprosthetic heart valves (BHVs) are still a promising way to solve this problem. However, there are still challenges in the use of BHVs. For example, their longevity is still unsatisfactory due to the defects, such as thrombosis, structural valve degeneration, calcification, insufficient re-endothelialization, and the inflammatory response. Therefore, strategies and methods are needed to effectively improve the biocompatibility and longevity of BHVs. This review describes the recent research advances in BHVs and strategies to improve their biocompatibility and longevity.
瓣膜性心脏病(VHD)已成为人类的负担和日益严重的公共卫生问题,在全球范围内导致了大量的发病率和死亡率。越来越多的严重 VHD 患者需要接受心脏瓣膜置换手术,对人工心脏瓣膜的需求也很高。然而,供体的同种异体瓣膜缺乏,无法满足临床实践的需要。机械心脏瓣膜在心血管系统中植入后与血液接触,可激活凝血途径,导致血栓形成。因此,生物心脏瓣膜(BHVs)仍然是解决这个问题的一个很有前途的方法。然而,BHVs 的使用仍然存在挑战。例如,由于血栓形成、结构性瓣膜退化、钙化、再内皮化不足和炎症反应等缺陷,其耐久性仍然不尽人意。因此,需要有策略和方法来有效地提高 BHVs 的生物相容性和耐久性。本综述描述了 BHVs 的最新研究进展和提高其生物相容性和耐久性的策略。
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