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Pathological analyses of explanted bioprosthetic valves are frequently based upon gross observations and eventually X-ray screening and micro-CT. Leaflets are sampled for histology, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). A new avenue is hereby proposed. After gross observations and X-ray imaging, the valve is embedded in a hard resin prior to any dissection and cut into 300-μm slices for observation in nano-CT followed by Raman microspectroscopy, SEM and energy-dispersive X-ray spectroscopy (EDS). Ultimately, the slides are ground and stained for observation in light microscopy. This comprehensive platform was validated through the examination of three explanted bioprostheses harvested at reoperation after 33, 10, and 2 years. The first one showed massive endophytic mineralisation mostly located along plots of the stent with loss at the tips of leaflets. Mineral deposits developed in the vicinity of the stent in the second valve implanted for 10 years. The mineralisation was limited to the tips of the stent in the third one. Those observations shall contribute to designing new generations of devices. The embedding of complete valves in hard resin brings a breakthrough in the understanding of their behaviours. This platform requires refinements before a consensus could be reached.

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Investigation of Explanted Bioprosthetic Heart Valves: A Comprehensive Evaluation Platform

  • 章节

  • 发表日期：

    2025年

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  • Daniel Chappard,
  • Robert Guidoin,
  • Xinzhe Zhao,
  • Georgi Marinov,
  • Yu Yang,
  • Aisa Rassoli,
  • Éric Philippe,
  • Rachid Zegdi,
  • Tomás Cianciulli,
  • Denis Desaulniers,
  • Daniel How,
  • Vincent Coulombe,
  • Omar Prieto,
  • Jing Lin,
  • Nasser Fatouraee,
  • Bin Li,
  • Lu Wang,
  • Ze Zhang

摘要

Pathological analyses of explanted bioprosthetic valves are frequently based upon gross observations and eventually X-ray screening and micro-CT. Leaflets are sampled for histology, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). A new avenue is hereby proposed. After gross observations and X-ray imaging, the valve is embedded in a hard resin prior to any dissection and cut into 300-μm slices for observation in nano-CT followed by Raman microspectroscopy, SEM and energy-dispersive X-ray spectroscopy (EDS). Ultimately, the slides are ground and stained for observation in light microscopy. This comprehensive platform was validated through the examination of three explanted bioprostheses harvested at reoperation after 33, 10, and 2 years. The first one showed massive endophytic mineralisation mostly located along plots of the stent with loss at the tips of leaflets. Mineral deposits developed in the vicinity of the stent in the second valve implanted for 10 years. The mineralisation was limited to the tips of the stent in the third one. Those observations shall contribute to designing new generations of devices. The embedding of complete valves in hard resin brings a breakthrough in the understanding of their behaviours. This platform requires refinements before a consensus could be reached.