Poly-2-methyl-2-oxazoline–modified bioprosthetic heart valve leaflets have enhanced biocompatibility and resist structural degeneration

Abstract

Significance Heart valve disease affects millions, and since there is no effective medical therapy, surgical repair when possible—or more commonly, replacement—are the only treatments available. Bioprosthetic heart valves (BHV), the most frequently used valve replacements, are composed of heterograft tissue, typically fixed in glutaraldehyde, and prepared for human use either as surgically implantable devices or for transcatheter delivery. Protein-glycation limits the durability of BHV, contributing to device failure, often requiring reoperation after only a decade or less of functionality. This problem is addressed by modifying BHV leaflets with poly-2-methyl-2-oxazoline, effectively mitigating glycation and serum protein infiltration and enhancing biocompatibility.