Multiscale multimodal characterization and simulation of structural alterations in failed bioprosthetic heart valves
Abstract
Calcific degeneration is the most frequent type of heart valve failure, with rising incidence due to the ageing population. The gold standard treatment to date is valve replacement. Unfortunately, calcification oftentimes re-occurs in bioprosthetic substitutes, with the governing processes remaining poorly understood. Here, we present a multiscale, multimodal analysis of disturbances and extensive mineralisation of the collagen network in failed bioprosthetic bovine pericardium valve explants with full histoanatomical context. In addition to highly abundant mineralized collagen fibres and fibrils, calcified micron-sized particles previously discovered in native valves were also prevalent on the aortic as well as the ventricular surface of bioprosthetic valves. The two mineral types (fibres and particles) were detectable even in early-stage mineralisation, prior to any macroscopic calcification. Based on multiscale multimodal characterisation and high-fidelity simulations, we demonstrate that mineral occurrence coincides with regions exposed to high haemodynamic and biomechanical indicators. These insights obtained by multiscale analysis of failed bioprosthetic valves serve as groundwork for the evidence-based development of more durable alternatives. Show more
Permanent link
https://doi.org/10.3929/ethz-b-000628815Publication status
publishedExternal links
Journal / series
Acta BiomaterialiaVolume
Pages / Article No.
Publisher
ElsevierSubject
Collagen mineralisation; Calcification; Calcium phosphate; Electron microscopy; Small angle X-ray scattering; Fluid-structure interaction simulationsOrganisational unit
09675 - Herrmann, Inge Katrin (ehemalig) / Herrmann, Inge Katrin (former)
Funding
181290 - Integrative Engineering of Metal Oxide Nanohybrid-based Surgical Adhesives: From Particle Design to Performance Assessment by Multiscale Analytics (SNF)
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Is new version of: http://hdl.handle.net/20.500.11850/601781
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