Ex Vivo Model for Bioprosthetic Valve Calcification via Stem Cell Differentiation to Bone
Calcific aortic stenosis is the most common indication for surgical valve replacement in the United States and Europe . Currently, mechanical versus bioprosthetic heart valves are the two options for valve replacement. The choice of valve depends on patient characteristics at the time of surgery . Bioprosthetic heart valves have decreased risk of thrombosis, therefore decreasing the need for anticoagulation. It is estimated that 20–30 % of implanted bioprosthetic heart valves will have some degree of hemodynamic dysfunction at 10 years. For years, the mechanisms of valve degeneration were thought to be due to a passive process in which calcium sticks to the valve directly from the circulation. However, recent studies have demonstrated risk factors for bioprosthetic valve calcification that are similar to vascular atherosclerosis [3, 4]. Furthermore, recent pathologic studies  have clearly shown that an inflammatory reaction develops in these calcifying bioprosthesis, which including lipid deposits, inflammatory cell infiltration, and bone matrix proteins expression.
- 2.Bonow RO, Carabello BA, Kanu C, de Leon Jr AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT, O’Rourke RA, Otto CM, Shah PM, Shanewise JS, Smith Jr SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 2006;114:e84–231.PubMedCrossRefGoogle Scholar
- 3.Antonini-Canterin F, Zuppiroli A, Popescu BA, Granata G, Cervesato E, Piazza R, Pavan D, Nicolosi GL. Effect of statins on the progression of bioprosthetic aortic valve degeneration. Am J Cardiol. 2003;92(12):1479–82.Google Scholar
- 7.Caira FC, Stock SR, Gleason TG, McGee EC, Huang J, Bonow RO, Spelsberg TC, McCarthy PM, Rahimtoola SH, Rajamannan NM. Human degenerative valve disease is associated with up-regulation of low-density lipoprotein receptor-related protein 5 receptor-mediated bone formation. J Am Coll Cardiol. 2006;47:1707–12.PubMedCentralPubMedCrossRefGoogle Scholar