Heart valve with reduced calcification
A method for manufacturing a heart valve using bioprosthetic tissue that exhibits reduced in vivo calcification. The method includes applying a calcification mitigant such as a capping agent or an antioxidant to the tissue to specifically inhibit oxidation in tissue. Also, the method can be used to inhibit oxidation in dehydrated tissue. The capping agent suppresses the formation of binding sites in the tissue that are exposed or generated by the oxidation and otherwise would, upon implant, attract calcium, phosphate, immunogenic factors, or other precursors to calcification. In one method, tissue leaflets in assembled bioprosthetic heart valves are pretreated with an aldehyde capping agent prior to dehydration and sterilization.
1. A method for manufacturing a heart valve, the method comprising:
exposing a heart valve to a solution comprising a capping agent, wherein the capping agent comprises an amino alcohol;
treating the heart valve with a glycerol treatment solution;
packaging the heart valve; and
sterilizing the packaged heart valve.
2. The method of claim 1 , wherein the heart valve is crosslinked before the exposing.
3. The method of claim 2 , wherein the heart valve is crosslinked with an aldehyde.
4. The method of claim 3 , wherein the aldehyde is glutaraldehyde.
5. The method of claim 1 , wherein:
the heart valve comprises functional groups comprising one or both of aldehyde groups and carboxylic acid groups; and
the exposing at least partially blocks, removes or alters the functional groups.
6. The method of claim 1 , wherein: the amino alcohol is an ethanolamine.
7. The method of claim 1 , wherein the glycerol treatment solution comprises a reducing agent.
8. The method of claim 7 , wherein the reducing agent is sodium borohydride or sodium cyanoborohydride.
9. The method of claim 1 , wherein the exposing is performed at room temperature.
10. The method of claim 1 , further comprising rinsing the heart valve following the exposing.
11. The method of claim 1 , wherein the glycerol treatment solution comprises 75 wt % glycerol and 25 wt % ethanol.
12. The method of claim 1 , wherein the treating comprises soaking the heart valve in the glycerol treatment solution.
13. The method of claim 12 , wherein the soaking is performed for one hour at room temperature.
14. The method of claim 1 , further comprising placing the heart valve in a clean hood to allow any excess glycerol treatment solution to evaporate or drip off the heart valve after the treating and before the sterilizing.
15. The method of claim 1 , wherein the packaging comprises placing the heart valve in a double sterile barrier packaging.
16. The method of claim 1 , wherein the sterilizing is performed with ethylene oxide.
17. A method for manufacturing a bioprosthetic heart valve, the method comprising:
treating a bioprosthetic heart valve comprising tissue leaflets with a solution comprising a capping agent;
wherein the capping agent comprises an amino alcohol;
wherein the tissue leaflets comprise functional groups comprising one or both of aldehyde groups and carboxylic acid groups; and
wherein the treating at least partially blocks, removes or alters the functional groups.
18. The method of claim 17 , wherein the tissue leaflets are cross-linked before the treating.
19. The method of claim 17 , further comprising treating the bioprosthetic heart valve with a glycerol treatment solution.
20. The method of claim 19 , further comprising placing the bioprosthetic heart valve in a clean hood to allow any excess glycerol treatment solution to evaporate or drip off the bioprosthetic heart valve after the treating.
21. The method of claim 17 , further comprising packaging the bioprosthetic heart valve and sterilizing the bioprosthetic heart valve after the packaging.
22. The method of claim 21 , wherein the packaging comprises placing the bioprosthetic heart valve in a double sterile barrier packaging.
23. The method of claim 22 , wherein the sterilizing is performed using ethylene oxide.
24. The method of claim 17 , wherein the solution containing the capping agent further comprises a reducing agent.
25. The method of claim 24 , wherein the amino alcohol is ethanolamine and the reducing agent is sodium borohydride and/or sodium cyanoborohydride.
26. The method of claim 17 , further comprising agitating the solution containing the capping agent.
27. The method of claim 17 , wherein the tissue leaflets are bovine pericardial leaflets.
28. A method for manufacturing a heart valve, the method comprising:
exposing a heart valve to one or more capping agents selected from the group consisting of: an amino alcohol, a hydroxylysine, an amino sulfonate, a taurine, an amino sulfate, a dextran sulfate, a chondroitin sulfate, a polyvinyl alcohol, a polyethyleneimine, an alpha-dicarbonyl, a methylglyoxal, a 3-deoxyglucosone, a glyoxal, a hydrazide, an adipic hydrazide, an N,N-disuccinimidyl carbonate, and a 2-chloro-1-methylpyridium iodide;
packaging the heart valve; and
sterilizing the heart valve after packaging.
29. The method of claim 28 , wherein the heart valve is crosslinked before the exposing.
30. The method of claim 29 , wherein the heart valve is crosslinked with an aldehyde.
31. The method of claim 30 , wherein the aldehyde is glutaraldehyde.
32. The method of claim 28 , wherein:
the heart valve comprises functional groups;
the functional groups comprise one or both of aldehyde groups and carboxylic acid groups; and
the exposing at least partially blocks, removes, or alters the functional groups.
33. The method of claim 28 , further comprising exposing the heart valve to one or more reducing agents.
34. The method of claim 33 , wherein the one or more reducing agents comprise one or more of sodium borohydride and sodium cyanoborohydride.
35. The method of claim 28 , further comprising treating the heart valve with a glycerol treatment solution.
36. The method of claim 35 , wherein the glycerol treatment solution comprises 75 wt % glycerol and 25 wt % ethanol.
37. The method of claim 35 , wherein the glycerol treatment solution further comprises a reducing agent.
38. The method of claim 35 , wherein the treating comprises soaking the heart valve in the glycerol treatment solution.
39. The method of claim 38 , wherein the soaking is performed for one hour at room temperature.
40. The method of claim 35 , further comprising placing the heart valve in a clean hood to allow any excess glycerol treatment solution to evaporate or drip off the heart valve after the treating and before the sterilizing.
41. The method of claim 28 , wherein the packaging comprises placing the heart valve in a double sterile barrier packaging.
42. The method of claim 28 , wherein the sterilizing is performed with ethylene oxide.