Bioactive surface coating for preventing mechanical heart valve thrombosis.

[en] BACKGROUND: Prosthetic heart valves are the only treatment for most patients with severe valvular heart disease. Mechanical valves, made of metallic components, are the most long-lasting type of replacement valves. However, they are prone to thrombosis and require permanent anticoagulation and monitoring, which leads to higher risk of bleeding and impacts the patient's quality of life. OBJECTIVES: To develop a bioactive coating for mechanical valves with the aim to prevent thrombosis and improve patient outcomes. METHODS: We used a catechol-based approach to produce a drug-releasing multilayer coating adherent to mechanical valves. The hemodynamic performance of coated Open Pivot valves was verified in a heart model tester, and coating durability in the long term was assessed in a durability tester producing accelerated cardiac cycles. Coating antithrombotic activity was evaluated in vitro with human plasma or whole blood under static and flow conditions and in vivo after surgical valve implantation in a pig's thoracic aorta. RESULTS: We developed an antithrombotic coating consisting of ticagrelor- and minocycline-releasing cross-linked nanogels covalently linked to polyethylene glycol. We demonstrated the hydrodynamic performance, durability, and hemocompatibility of coated valves. The coating did not increase the contact phase activation of coagulation, and it prevented plasma protein adsorption, platelet adhesion, and thrombus formation. Implantation of coated valves in nonanticoagulated pigs for 1 month efficiently reduced valve thrombosis compared with noncoated valves. CONCLUSION: Our coating efficiently inhibited mechanical valve thrombosis, which might solve the issues of anticoagulant use in patients and the number of revision surgeries due to valve thrombosis despite anticoagulation.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Lancellotti, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie

Aqil, Abdelhafid ; University of Liège (ULiège), Complex and Entangled Systems from Atoms to Materials (CESAM) Research Unit, Center for Education and Research on Macromolecules (CERM), Belgium

MUSUMECI, Lucia ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie cardio-vasculaire et thoracique

Jacques, Nicolas ; Université de Liège - ULiège > GIGA > GIGA Cardiovascular Sciences - Cardiology

Ditkowski, Bartosz ; Laboratory of Cardiology, GIGA Institute, and Department of Cardiology, Centre

Debuisson, Margaux ; Université de Liège - ULiège > GIGA > GIGA Cardiovascular Sciences - Cardiology

Thiry, Marc ; Laboratory of Cellular and Tissular Biology, GIGA-Neurosciences, Cell Biology,

Dupont, Julien ; Department of Clinical Sciences, Faculty of Veterinary Medicine, University of

Gougnard, Alexandra ; Université de Liège - ULiège > Département d'Ens. et de Clinique des Equidés (DCE) > Anesthésiologie et réanimation des équidés

Sandersen, Charlotte ; Université de Liège - ULiège > Dépt d'Ens. et de Clinique des animaux de Compagnie (DCC) > Anesthésiologie et réanimation des animaux de compagnie

More authors (6 more)

Language :

English

Title :

Bioactive surface coating for preventing mechanical heart valve thrombosis.

Publication date :

15 May 2023

Journal title :

Journal of Thrombosis and Haemostasis

ISSN :

1538-7933

eISSN :

1538-7836

Peer reviewed :

Peer reviewed

Commentary :

Available on ORBi :

since 03 July 2023

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