Optimizing Glutaraldehyde-Fixed Tissue Heart Valves with Chondroitin Sulfate Hydrogel for Endothelialization and Shielding against Deterioration

Abstract

<p class="first" id="P3">Porcine glutaraldehyde-fixed pericardium is widely used to replace human heart valves. Despite the stabilizing effects of glutaraldehyde fixation, the lack of endothelialization and the occurrence of immune reactions contribute to calcification and structural valve deterioration, which is particularly significant in young patients where valve longevity is crucial. This report shows an optimization system to enhance endothelialization of fixed pericardium to mimic the biological function of a native heart valve. The glutaraldehyde detoxification together with the application of a biodegradable methacrylated chondroitin sulfate hydrogel reduces aldehydes cytotoxicity, increases the migration and proliferation of endothelial cells, the recruitment of endothelial cell progenitors, and confers thrombo-resistance in fixed pericardium. The combination of glutaraldehyde detoxification and a coating with chondroitin sulfate hydrogel promotes <i>in situ</i> mechanisms of endothelialization in fixed pericardium. We offer a new solution to improve the long-life of bioprosthetic valves and explore means of making valves suitable to endothelialization. </p><p id="P4"> <div class="figure-container so-text-align-c"> <img alt="" class="figure" src="/document_file/b932365f-c76c-488d-8037-fde63a1b765d/PubMedCentral/image/nihms-984103-f0001.jpg"/> </div> </p>