Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials

Heart valve disease contributes to cardiovascular disease–associated death. Bioprosthetic heart valves have emerged as a preferred option for heart valve replacement due to their superior hemodynamic performance and reduced need for lifelong anticoagulation. However, their long‐term durability is co...

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Main Authors: Hanluo Li, Shenghua Li, Yalan Lei, Ming Sun, Chunlin Wu, Xueli Wang, Shiwen Xiong, Qing Wang, Sini Kang, Song Chen, Xiaoke Shang
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.125.043061
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author Hanluo Li
Shenghua Li
Yalan Lei
Ming Sun
Chunlin Wu
Xueli Wang
Shiwen Xiong
Qing Wang
Sini Kang
Song Chen
Xiaoke Shang
author_facet Hanluo Li
Shenghua Li
Yalan Lei
Ming Sun
Chunlin Wu
Xueli Wang
Shiwen Xiong
Qing Wang
Sini Kang
Song Chen
Xiaoke Shang
author_sort Hanluo Li
collection DOAJ
description Heart valve disease contributes to cardiovascular disease–associated death. Bioprosthetic heart valves have emerged as a preferred option for heart valve replacement due to their superior hemodynamic performance and reduced need for lifelong anticoagulation. However, their long‐term durability is compromised by calcification, immunogenicity, and structural degeneration, primarily due to glutaraldehyde fixation and residual xenogeneic antigens. This review highlights recent advances in biomaterial optimization, with an emphasis on decellularization and cross‐linking strategies aimed at improving the mechanical stability and biocompatibility of bioprosthetic heart valves. The effectiveness and limitations of various decellularization agents, including nonionic, ionic, and amphoteric detergents, are critically evaluated, alongside novel cross‐linking reagents such as ribose, genipin, and polyphenols. Furthermore, the development of polymeric heart valves and nanocomposite materials is also explored as a means to address the limitations of conventional mechanical and bioprosthetic valves. Emerging strategies involving gene‐editing technologies, stem cell therapies, and tissue engineering hold considerable promise for the development of next‐generation, patient‐specific, and immunotolerant heart valve prostheses. Collectively, these innovations are driving a paradigm shift toward long‐lasting, bioactive, and regenerative heart valve replacements.
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institution Kabale University
issn 2047-9980
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publishDate 2025-08-01
publisher Wiley
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series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-60a69e16e3284d04835ea9099d5167762025-08-20T07:24:44ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141610.1161/JAHA.125.043061Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric MaterialsHanluo Li0Shenghua Li1Yalan Lei2Ming Sun3Chunlin Wu4Xueli Wang5Shiwen Xiong6Qing Wang7Sini Kang8Song Chen9Xiaoke Shang10National “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaHubei Provincial Enterprise Technology Center, Wuhan Vickor Medical Technology Co. Wuhan ChinaHubei Provincial Enterprise Technology Center, Wuhan Vickor Medical Technology Co. Wuhan ChinaHubei Provincial Enterprise Technology Center, Wuhan Vickor Medical Technology Co. Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaNational “111” Center for Cellular Regulation and Molecular Pharmaceutics, Cooperative Innovation Center of Industrial Fermentation (Ministry of Education and Hubei Province), School of Life and Health Sciences, Hubei University of Technology Wuhan ChinaHeart valve disease contributes to cardiovascular disease–associated death. Bioprosthetic heart valves have emerged as a preferred option for heart valve replacement due to their superior hemodynamic performance and reduced need for lifelong anticoagulation. However, their long‐term durability is compromised by calcification, immunogenicity, and structural degeneration, primarily due to glutaraldehyde fixation and residual xenogeneic antigens. This review highlights recent advances in biomaterial optimization, with an emphasis on decellularization and cross‐linking strategies aimed at improving the mechanical stability and biocompatibility of bioprosthetic heart valves. The effectiveness and limitations of various decellularization agents, including nonionic, ionic, and amphoteric detergents, are critically evaluated, alongside novel cross‐linking reagents such as ribose, genipin, and polyphenols. Furthermore, the development of polymeric heart valves and nanocomposite materials is also explored as a means to address the limitations of conventional mechanical and bioprosthetic valves. Emerging strategies involving gene‐editing technologies, stem cell therapies, and tissue engineering hold considerable promise for the development of next‐generation, patient‐specific, and immunotolerant heart valve prostheses. Collectively, these innovations are driving a paradigm shift toward long‐lasting, bioactive, and regenerative heart valve replacements.https://www.ahajournals.org/doi/10.1161/JAHA.125.043061biological heart valvesbiomaterialscrosslinkingdecellularizationheart valve tissue engineeringpolymeric heart valves
spellingShingle Hanluo Li
Shenghua Li
Yalan Lei
Ming Sun
Chunlin Wu
Xueli Wang
Shiwen Xiong
Qing Wang
Sini Kang
Song Chen
Xiaoke Shang
Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
biological heart valves
biomaterials
crosslinking
decellularization
heart valve tissue engineering
polymeric heart valves
title Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
title_full Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
title_fullStr Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
title_full_unstemmed Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
title_short Advancements and Perspectives in the Bioprosthetic Heart Valve: A Comprehensive Review on Biomaterial Processing and Emerging Polymeric Materials
title_sort advancements and perspectives in the bioprosthetic heart valve a comprehensive review on biomaterial processing and emerging polymeric materials
topic biological heart valves
biomaterials
crosslinking
decellularization
heart valve tissue engineering
polymeric heart valves
url https://www.ahajournals.org/doi/10.1161/JAHA.125.043061
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