Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

Huitzilihuitl Saucedo-Orozco, Jesus Vargas-Barron, Ricardo Márquez-Velazco, Julio Iván Farjat-Pasos, Karla Susana Martinez-Zavala, Valentin Jiménez-Rojas, Sergio Andres Criales-Vera, Jose Antonio Arias-Godínez, Giovanni Fuentevilla-Alvarez, Veronica Guarner-Lans, Israel Perez-Torres, Gabriela Melendez-Ramirez, Tomas Efrain Sanchez Perez, Maria Elena Soto, Huitzilihuitl Saucedo-Orozco, Jesus Vargas-Barron, Ricardo Márquez-Velazco, Julio Iván Farjat-Pasos, Karla Susana Martinez-Zavala, Valentin Jiménez-Rojas, Sergio Andres Criales-Vera, Jose Antonio Arias-Godínez, Giovanni Fuentevilla-Alvarez, Veronica Guarner-Lans, Israel Perez-Torres, Gabriela Melendez-Ramirez, Tomas Efrain Sanchez Perez, Maria Elena Soto

Abstract

Background: The evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve durability and functionality of the prostheses. It is our objective METHODS: In this study, we included a cohort of patients with aortic valve damage treated by AVR with mechanical prosthesis, bio prosthesis and we included a control group.

Results: We found that IL-4 and osteopontin levels were higher in patients with mechanical vs biological prostheses (p=0.01 and p=0.04, respectively), osteoprotegerin (OPG) levels were decreased (p=0.01), women had lower levels of ET-1 and IL-6, (p=0.02) (p=0.04), respectively. Patients older than 60 years had decreased levels of IL-1ß p<0.001) and a higher concentration of IL-4 p<0.05). IL-1ß, OPG and TNFα were higher in patients with less than 5 years of evolution vs more than 10 years (p=0.004, p=0.02 and p=0.03, respectively). Factors such as age, gender, prosthetic and elevated IL-1B and ET-1 levels are associated with valve dysfunction prosthetic. These results indicate that the inflammatory involvement present prior to valve replacement may be perpetuated by various factors in the long term.

Conclusions: The findings provide us with the opportunity to effectively treat patients with AVR in the postoperative period, which could prolong the functionality of the bio prostheses.

Trial registration number: NCT04557345.

Keywords: Aortic Valve Insufficiency; Aortic Valve Stenosis; Echocardiography; Heart Valve Prosthesis.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Bioprosthesis INC, manufactured at the ‘Ignacio Chávez’ National Cardiology Institute.
Figure 2
Figure 2
The Kaplan-Meier survival estimates did not show significant differences between patients with mechanical aortic valve and bioprosthetic valve.

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