A Durable Porcine Pericardial Surgical Bioprosthetic Heart Valve: a Proof of Concept

J Cardiovasc Transl Res. 2019 Aug;12(4):331-337. doi: 10.1007/s12265-019-09868-3. Epub 2019 Feb 12.

Abstract

Bioprosthetic leaflets made from animal tissues are used in the majority of surgical and transcatheter cardiac valve replacements. This study develops a new surgical bioprosthesis, using porcine pericardial leaflets. Porcine pericardium was obtained from genetically engineered pigs with a mutation in the GGTA-1 gene (GTKO) and fixed in 0.6% glutaraldehyde, and used to develop a new surgical valve design. The valves underwent in vitro hydrodynamic test in a pulse duplicator and high-cycled accelerated wear testing and were evaluated for acute haemodynamics and thrombogenicity in a juvenile sheep implant study for 48 h. The porcine surgical pericardial heart valves (pSPHVs) exhibited excellent hydrodynamics and reached 200 million cycles of in vitro durability, with no observable damage. Juvenile sheep implants demonstrated normal valve function with no acute thrombogenic response for either material. The pSPHV incorporates a minimalistic construction method using a tissue-to-tissue design to cover the stent. This new design is a proof of concept alternative to the use of bovine pericardium and synthetic fabric in surgical bioprosthetic heart valves.

Keywords: Biological heart valve; Calcification; Gal knockout; Porcine pericardium; Xenotransplantation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Genetically Modified
  • Bioprosthesis*
  • Equipment Failure Analysis
  • Galactosyltransferases / genetics
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Hemodynamics
  • Heterografts
  • Hydrodynamics
  • Materials Testing
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery*
  • Mutation
  • Pericardium / transplantation*
  • Proof of Concept Study
  • Prosthesis Failure
  • Stress, Mechanical
  • Sus scrofa / genetics

Substances

  • Galactosyltransferases
  • alpha-1,3-galactosyltransferase 1, porcine