scholarly journals Is Cell Regeneration and Infiltration a Double Edged Sword for Porcine Aortic Valve Deterioration: A Large Cohort of Histopathological Analysis

2021 ◽  
Author(s):  
Li Li ◽  
Xuejing Duan ◽  
Hongyue Wang ◽  
Yang Sun ◽  
Wei Zhao ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Immunohistochemical Staining ◽  
Large Cohort ◽  
Western World ◽  
Histopathological Analysis ◽  
Cell Regeneration ◽  
Valve Interstitial Cells ◽  
Spongy Layer ◽  
Pathologic Features ◽  
Structural Valve Deterioration

Abstract Background Bioprostheses are the commonest prostheses used for valve replacement in the western world. The major flaw of bioprostheses is the occurrence of structural valve deterioration (SVD). The objective of this study was to assess in a large cohort of patients the pathologic features of porcine aortic valve (PAV) SVD based on histomorphological and immunopathological features.Methods and materials 109 cases of resected PAV were observed grossly and histopathologically. The type and amount of infiltrated cells were evaluated in the different type of bioprosthetic SVD by immunohistochemical staining . Results The most common cause of SVD was calcification, leaflet dehiscence and tear (23.9%,19.3% and 18.3%, respectively). Immunohistochemical staining demonstrated that vimentin positive cells aggregated around the calcified area in calcified PAV. Macrophages infiltrated in the calcified, lacerated and dehiscence PAV. However, MMP-1 expression was mainly found in the lacerated PAV. The VIM(+)/SMA(-) and VIM(+)/CD31(-) cells were found in PAV. The endothelia rate of dehiscence leaflets were higher than that of calcified and lacerated leaflets. A large amount of CD31 positive cells aggregated in the spongy layer in the lacerated and dehiscence PAV. Conclusions Cell regeneration and infiltration is a double edged sword for the PAV deterioration. Valve interstitial cells (VIC) have essential role in PAV calcification. Macrophages infiltration maybe involve in the different type of SVD, but only MMP-1expression involves in leaflets laceration. VIM(+)/CD31(-) valve endothelial cells (VECs) protect the PAV against the formation of calcified and lacerated lesions. The existence of untransformed VECs maybe one of pathologic substrate of PAV tear and dehiscence, although they can prevent VICs activation and subsequent valve fibrosis and calcification.

A valve-in-valve transcatheter aortic valve implantation with commissural alignment using advanced imaging reconstruction: a case report

2020 ◽  
Vol 3 (10) ◽  
pp. 01-05
Author(s):  
Marco Angelillis
Keyword(s):  
Aortic Valve ◽  
Severe Aortic Stenosis ◽  
Coronary Intervention ◽  
Easy Access ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Structural Valve Deterioration ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Transcatheter valve in valve (ViV) implantation actually represents a valid alternative to surgical reinterventions in patients with previous surgical aortic valve replacement (AVR). In patients less than 80 years old, it is crucial to correctly position the new valve leaving a feasible and easy access to coronary ostia, both for future percutaneous coronary intervention (PCI) than for a future possible TAVinTAV procedure. We report a 71 year old man with prior AVR presented with structural valve deterioration (SVD) leading to severe aortic stenosis. In order to guarantee comfortable coronary access we aligned, the commissures of the new percutaneous valve with the ones of the surgical bioprothesis by reconstructing the headframes of the surgical bioprosthesis with computer tomography (CT) and fluoro-CT.

3D Contractile Responses of Normal and Diseased Human Aortic Valve Interstitial Cells

2021 ◽  
Vol 5 (sup1) ◽  
pp. 1-1
Author(s):  
Alex Khang ◽  
Chiara Camillo ◽  
Giovanni Ferrari ◽  
Michael S. Sacks
Keyword(s):  
Aortic Valve ◽  
Interstitial Cells ◽  
Contractile Responses ◽  
Valve Interstitial Cells ◽  
Human Aortic Valve

scholarly journals Interleukin-37 suppresses the osteogenic responses of human aortic valve interstitial cells in vitro and alleviates valve lesions in mice

2017 ◽  
Vol 114 (7) ◽  
pp. 1631-1636 ◽  
Author(s):  
Qingchun Zeng ◽  
Rui Song ◽  
David A. Fullerton ◽  
Lihua Ao ◽  
Yufeng Zhai ◽  
...  
Keyword(s):  
Aortic Valve ◽  
High Fat Diet ◽  
Aortic Valve Disease ◽  
Valve Disease ◽  
High Fat ◽  
Calcific Aortic Valve Disease ◽  
Aortic Valves ◽  
Valve Interstitial Cells ◽  
Valve Lesions ◽  
Osteogenic Factors

Calcific aortic valve disease is a chronic inflammatory process, and aortic valve interstitial cells (AVICs) from diseased aortic valves express greater levels of osteogenic factors in response to proinflammatory stimulation. Here, we report that lower cellular levels of IL-37 in AVICs of diseased human aortic valves likely account for augmented expression of bone morphogenetic protein-2 (BMP-2) and alkaline phosphatase (ALP) following stimulation of Toll-like receptor (TLR) 2 or 4. Treatment of diseased AVICs with recombinant human IL-37 suppresses the levels of BMP-2 and ALP as well as calcium deposit formation. In mice, aortic valve thickening is observed when exposed to a TLR4 agonist or a high fat diet for a prolonged period; however, mice expressing human IL-37 exhibit significantly lower BMP-2 levels and less aortic valve thickening when subjected to the same regimens. A high fat diet in mice results in oxidized low-density lipoprotein (oxLDL) deposition in aortic valve leaflets. Moreover, the osteogenic responses in human AVICs induced by oxLDL are suppressed by recombinant IL-37. Mechanistically, reduced osteogenic responses to oxLDL in human AVICs are associated with the ability of IL-37 to inhibit NF-κB and ERK1/2. These findings suggest that augmented expression of osteogenic factors in AVICs of diseased aortic valves from humans is at least partly due to a relative IL-37 deficiency. Because recombinant IL-37 suppresses the osteogenic responses in human AVICs and alleviates aortic valve lesions in mice exposed to high fat diet or a proinflammatory stimulus, IL-37 has therapeutic potential for progressive calcific aortic valve disease.

scholarly journals Porcine aortic valve interstitial cells are rich in mesenchymal progenitors

2008 ◽  
Vol 22 (S1) ◽  
Author(s):  
Jan‐Hung Chen ◽  
Cindy Ying Yin Yip ◽  
Eli D. Sone ◽  
Craig A. Simmons
Keyword(s):  
Aortic Valve ◽  
Interstitial Cells ◽  
Valve Interstitial Cells ◽  
Mesenchymal Progenitors

scholarly journals Isolation and culture of rat aortic valve interstitial cells

2015 ◽  
Vol 15 (11) ◽  
pp. 893-896 ◽  
Author(s):  
Huiqiang Chen ◽  
Wei Cui ◽  
Haijuan Hu ◽  
Jing Liu
Keyword(s):  
Aortic Valve ◽  
Interstitial Cells ◽  
Valve Interstitial Cells

scholarly journals Current Clinical Evidence on Rapid Deployment Aortic Valve Replacement: Sutureless Aortic Bioprostheses

2016 ◽  
Vol 11 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Glenn R. Barnhart ◽  
Malakh Lal Shrestha
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Western World ◽  
High Risk Population ◽  
Additional Tool ◽  
Age Related ◽  
Number Of Patients ◽  
Rapid Deployment

Aortic stenosis is the most common valvular heart disease in the Western world. It is caused primarily by age-related degeneration and progressive calcification typically detected in patients 65 years and older. In patients presenting with symptoms of heart failure, the average survival rate is only 2 years without appropriate treatment. Approximately one half of all patients die within the first 2 to 3 years of symptom onset. In addition, the age of the patients presenting for aortic valve replacement (AVR) is increased along with the demographic changes. The Society of Thoracic Surgeons (STS) database shows that the number of patients older than 80 years has increased from 12% to 24% during the past 20 years. At the same time, the percentage of candidates requiring AVR as well as concomitant coronary bypass surgery has increased from 5% to 25%. Surgical AVR continues to be the criterion standard for treatment of aortic stenosis, improving survival and quality of life. Recent advances in prosthetic valve technology, such as transcatheter AVR, have expanded the indication for AVR to the extreme high-risk population, and the most recent surgical innovation, rapid deployment AVR, provides an additional tool to the surgeons’ armamentarium.

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