Degeneration of Bioprosthetic Heart Valves: Update 2020.
J Am Heart Assoc
; 9(19): e018506, 2020 10 20.
Article
en En
| MEDLINE
| ID: mdl-32954917
ABSTRACT
The implantation of bioprosthetic heart valves (BHVs) is increasingly becoming the treatment of choice in patients requiring heart valve replacement surgery. Unlike mechanical heart valves, BHVs are less thrombogenic and exhibit superior hemodynamic properties. However, BHVs are prone to structural valve degeneration (SVD), an unavoidable condition limiting graft durability. Mechanisms underlying SVD are incompletely understood, and early concepts suggesting the purely degenerative nature of this process are now considered oversimplified. Recent studies implicate the host immune response as a major modality of SVD pathogenesis, manifested by a combination of processes phenocopying the long-term transplant rejection, atherosclerosis, and calcification of native aortic valves. In this review, we summarize and critically analyze relevant studies on (1) SVD triggers and pathogenesis, (2) current approaches to protect BHVs from calcification, (3) obtaining low immunogenic BHV tissue from genetically modified animals, and (4) potential strategies for SVD prevention in the clinical setting.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Bioprótesis
/
Falla de Prótesis
/
Prótesis Valvulares Cardíacas
/
Implantación de Prótesis de Válvulas Cardíacas
/
Enfermedades de las Válvulas Cardíacas
Límite:
Humans
Idioma:
En
Revista:
J Am Heart Assoc
Año:
2020
Tipo del documento:
Article