Researchers identify reasons for failure of animal heart tissue used in replacement heart valves for treatment of aortic stenosis Study will result in pre-screening of tissues and prevention of failur...

We have developed a unique method for pre-clinical heart valve prostheses evaluation of calcification propensity. Results from the test can directly be translated into improvements of prostheses desi...

List of projects funded by PSI Foundation.

Background Prophylactic mesh placement lowers incisional hernia risk, but the ideal mesh type and anatomical plane remain unclear. This study aims to determine which mesh and placement site are associated with the lowest rates of incisional hernia and surgical site infection after stoma closure. Methods A systematic review of PubMed, the Cochrane Library, and Embase was conducted to identify comparative studies evaluating the type of mesh and/or the anatomical plane of mesh placement in the abdominal wall following stoma closure for the prevention of incisional hernias. A network meta-analysis was performed to assess incisional hernia and surgical site infection. Results We included 11 included studies involving 2,148 patients. The use of prosthetic mesh (OR = 0.137, 95%CI 0.056–0.335), bioprosthetic mesh (OR = 0.171, 95%CI 0.061–0.473), and biological mesh (OR = 0.528, 95%CI 0.336–0.828) was associated with a lower risk of incisional hernia compared to no mesh use. Mesh placement in a retromuscular position (OR = 0.068, 95%CI 0.024–0.189), onlay position (OR = 0.224, 95%CI 0.095–0.524), and intraperitoneal position (OR = 0.564, 95%CI 0.366–0.869) was associated with a lower risk of incisional hernia compared to no mesh use. No statistically significant differences were observed in surgical site infection risk between the use of different mesh types or anatomical planes and no mesh placement. Conclusion Prophylactic placement of prosthetic or bioprosthetic mesh in the retromuscular plane at the time of stoma closure is the most effective approach for reducing the incidence of incisional hernia and surgical site infection.

Xenogenic biomaterial durability, including bioprosthetic heart valves (BPVs), is compromised by pathological extracellular matrix (ECM) remodeling, resulting in progressive structural degeneration. Mass spectrometry-based proteomics can help reveal BPV degeneration mechanisms; however, peptide sequence similarity between donor and host species complicates protein-level analysis. We present a cross-species proteomic analytical strategy for xenogenic biomaterials and cross-species proteomic datasets. In silico tryptic digestion of human and bovine protein databases identified over 400 overlapping proteins with a high protein percent identity. Explanted human BPV tissue was divided into macroscopically distinct regions of degeneration and analyzed by mass spectrometry. A peptide-level strategy quantified protein abundances in a species-delineated analysis. We highlighted degeneration region-specific depositions of key human ECM proteins and bovine ECM proteins whose abundance is time dependent. We demonstrated that single-species analysis of a cross-species proteome results in inaccurate quantification. This study highlights the importance of distinguishing between donor and host species proteomes for accurate protein quantification. While focused on clinically explanted biomaterials, our approach is broadly applicable to all forms of xenotransplantation and the use of xenogenic matrices.

Objectives Limited information is available regarding the impact of valve choice for patients with aortic stenosis (AS) undergoing surgical aortic valve replacement (SAVR) in Spain. Herein, we aimed to explore the potential cost-effectiveness of a new bioprosthetic valve with RESILIA tissue versus mechanical alternatives from a Spanish healthcare perspective. Methods Health outcomes, including quality-adjusted life years (QALYs), adverse events, and costs were estimated for two cohorts of patients with severe AS (aged ≥ 65 or 55–64 years) over a lifetime horizon employing a UK cost-effectiveness model adapted to Spanish clinical practice to compare a novel bioprosthesis versus mechanical alternatives. This model included a decision tree to describe short-term outcomes and a partitioned survival model to evaluate mortality and long-term outcomes. A panel of clinical experts validated the model methodology, including parameters and assumptions considered. Sensitivity analyses were performed to account for uncertainty. Results The novel bioprosthetic valve led to cost savings for both cohorts (€6209/patient for age ≥ 65 years; €8289/patient for ages 55–64 years). These were mainly driven by a reduction in anticoagulation- and adverse event-associated resources, outweighing the costs derived from more reoperations estimated with the novel bioprosthetic valve. An observable increase in QALYs was detected in both age groups (0.0051 and 0.0191, respectively). Hence, the novel bioprosthetic valve is expected to be a dominant alternative for patients 55 years or older who are eligible for SAVR. It remained cost-effective in > 98% of sensitivity analyses. Conclusions Our exploratory study indicates the novel RESILIA bioprosthetic valve as a potential alternative to mechanical valves for SAVR in patients 55 years or older can lead to budgetary cost savings and improved health outcomes in Spain.