Evaluation of pliable bioresorbable, elastomeric aortic valve prostheses in sheep during 12 months post implantation

Annemijn Vis; Bente J. de Kort; Wojciech Szymczyk; Jan Willem van Rijswijk; Sylvia Dekker; Rob Driessen; Niels Wijkstra; Paul F. Gründeman; Hans W.M. Niessen; Henk M. Janssen; Serge H.M. Söntjens; Patricia Y.W. Dankers; Anthal I.P.M. Smits; Carlijn V.C. Bouten; Jolanda Kluin

doi:10.1038/s42003-023-05533-3

Evaluation of pliable bioresorbable, elastomeric aortic valve prostheses in sheep during 12 months post implantation

Annemijn Vis
, Bente J. de Kort
, Wojciech Szymczyk
, Jan Willem van Rijswijk
, Sylvia Dekker
, Rob Driessen
, Niels Wijkstra
, Paul F. Gründeman
, Hans W.M. Niessen
, Henk M. Janssen
, Serge H.M. Söntjens
, Patricia Y.W. Dankers
, Anthal I.P.M. Smits
, Carlijn V.C. Bouten (Corresponding author)
, Jolanda Kluin (Corresponding author)

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

85 Downloads (Pure)

Abstract

Pliable microfibrous, bioresorbable elastomeric heart valve prostheses are investigated in search of sustainable heart valve replacement. These cell-free implants recruit cells and trigger tissue formation on the valves in situ. Our aim is to investigate the behaviour of these heart valve prostheses when exposed to the high-pressure circulation. We conducted a 12-month follow-up study in sheep to evaluate the in vivo functionality and neo-tissue formation of these valves in the aortic position. All valves remained free from endocarditis, thrombotic complications and macroscopic calcifications. Cell colonisation in the leaflets was mainly restricted to the hinge area, while resorption of synthetic fibers was limited. Most valves were pliable and structurally intact (10/15), however, other valves (5/15) showed cusp thickening, retraction or holes in the leaflets. Further research is needed to assess whether in-situ heart valve tissue engineering in the aortic position is possible or whether non-resorbable synthetic pliable prostheses are preferred.

Original language	English
Article number	1166
Number of pages	14
Journal	Communications biology
Volume	6
Issue number	1
DOIs	https://doi.org/10.1038/s42003-023-05533-3
Publication status	Published - Dec 2023

Funding

We are very grateful to Linda Grutterink and Mariella Volkers for taking and reporting the ultrasound measurements and to Bas van Klarenbosch for taking an emergency ultrasound examination on a very short notice. We thank Onno de Boer, Eva Landman and Neeltje van der Veen for their assistance with the histological analysis and data acquisition. We thank Andras Durko and Marcelle Uiterwijk for their help and expertise. We thank the veterinarians, perfusionists, biotechnicians and animal caretakers for their work and dedication involving the animal experiments. The author’s work is funded by Cardiovascular Onderzoek Nederland grant #CVON2012-01 1Valve, the Gravitation Program “Materials Driven Regeneration,” funded by the Netherlands Organization for Scientific Research, grant # 024.003.013 and by the HybridHeart project, funded by the European Union Horizon 2020 research and innovation programme under grant agreement #767195.

Funders	Funder number
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	024.003.013
European Union's Horizon 2020 - Research and Innovation Framework Programme	767195

Keywords

Animals
Sheep
Heart Valve Prosthesis
Aortic Valve/surgery
Follow-Up Studies
Absorbable Implants
Prosthesis Design
Bioprosthesis

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Vis, A., de Kort, B. J., Szymczyk, W., van Rijswijk, J. W., Dekker, S., Driessen, R., Wijkstra, N., Gründeman, P. F., Niessen, H. W. M., Janssen, H. M., Söntjens, S. H. M., Dankers, P. Y. W., Smits, A. I. P. M., Bouten, C. V. C., & Kluin, J. (2023). Evaluation of pliable bioresorbable, elastomeric aortic valve prostheses in sheep during 12 months post implantation. Communications biology, 6(1), Article 1166. https://doi.org/10.1038/s42003-023-05533-3

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abstract = "Pliable microfibrous, bioresorbable elastomeric heart valve prostheses are investigated in search of sustainable heart valve replacement. These cell-free implants recruit cells and trigger tissue formation on the valves in situ. Our aim is to investigate the behaviour of these heart valve prostheses when exposed to the high-pressure circulation. We conducted a 12-month follow-up study in sheep to evaluate the in vivo functionality and neo-tissue formation of these valves in the aortic position. All valves remained free from endocarditis, thrombotic complications and macroscopic calcifications. Cell colonisation in the leaflets was mainly restricted to the hinge area, while resorption of synthetic fibers was limited. Most valves were pliable and structurally intact (10/15), however, other valves (5/15) showed cusp thickening, retraction or holes in the leaflets. Further research is needed to assess whether in-situ heart valve tissue engineering in the aortic position is possible or whether non-resorbable synthetic pliable prostheses are preferred.",

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year = "2023",

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doi = "10.1038/s42003-023-05533-3",

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Vis, A, de Kort, BJ, Szymczyk, W, van Rijswijk, JW, Dekker, S, Driessen, R, Wijkstra, N, Gründeman, PF, Niessen, HWM, Janssen, HM, Söntjens, SHM , Dankers, PYW , Smits, AIPM , Bouten, CVC & Kluin, J 2023, 'Evaluation of pliable bioresorbable, elastomeric aortic valve prostheses in sheep during 12 months post implantation', Communications biology, vol. 6, no. 1, 1166. https://doi.org/10.1038/s42003-023-05533-3

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AU - Vis, Annemijn

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AU - Szymczyk, Wojciech

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AU - Dekker, Sylvia

AU - Driessen, Rob

AU - Wijkstra, Niels

AU - Gründeman, Paul F.

AU - Niessen, Hans W.M.

AU - Janssen, Henk M.

AU - Söntjens, Serge H.M.

AU - Dankers, Patricia Y.W.

AU - Smits, Anthal I.P.M.

AU - Bouten, Carlijn V.C.

AU - Kluin, Jolanda

PY - 2023/12

Y1 - 2023/12

N2 - Pliable microfibrous, bioresorbable elastomeric heart valve prostheses are investigated in search of sustainable heart valve replacement. These cell-free implants recruit cells and trigger tissue formation on the valves in situ. Our aim is to investigate the behaviour of these heart valve prostheses when exposed to the high-pressure circulation. We conducted a 12-month follow-up study in sheep to evaluate the in vivo functionality and neo-tissue formation of these valves in the aortic position. All valves remained free from endocarditis, thrombotic complications and macroscopic calcifications. Cell colonisation in the leaflets was mainly restricted to the hinge area, while resorption of synthetic fibers was limited. Most valves were pliable and structurally intact (10/15), however, other valves (5/15) showed cusp thickening, retraction or holes in the leaflets. Further research is needed to assess whether in-situ heart valve tissue engineering in the aortic position is possible or whether non-resorbable synthetic pliable prostheses are preferred.

AB - Pliable microfibrous, bioresorbable elastomeric heart valve prostheses are investigated in search of sustainable heart valve replacement. These cell-free implants recruit cells and trigger tissue formation on the valves in situ. Our aim is to investigate the behaviour of these heart valve prostheses when exposed to the high-pressure circulation. We conducted a 12-month follow-up study in sheep to evaluate the in vivo functionality and neo-tissue formation of these valves in the aortic position. All valves remained free from endocarditis, thrombotic complications and macroscopic calcifications. Cell colonisation in the leaflets was mainly restricted to the hinge area, while resorption of synthetic fibers was limited. Most valves were pliable and structurally intact (10/15), however, other valves (5/15) showed cusp thickening, retraction or holes in the leaflets. Further research is needed to assess whether in-situ heart valve tissue engineering in the aortic position is possible or whether non-resorbable synthetic pliable prostheses are preferred.

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KW - Sheep

KW - Heart Valve Prosthesis

KW - Aortic Valve/surgery

KW - Follow-Up Studies

KW - Absorbable Implants

KW - Prosthesis Design

KW - Bioprosthesis

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DO - 10.1038/s42003-023-05533-3

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C2 - 37964029

AN - SCOPUS:85176444367

SN - 2399-3642

VL - 6

JO - Communications biology

JF - Communications biology

IS - 1

M1 - 1166

ER -

Evaluation of pliable bioresorbable, elastomeric aortic valve prostheses in sheep during 12 months post implantation

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