Evidence map›Paper›PMID 41117258›Full record

ArticleArtificial organs2026

In Vitro Calcification of Bioprosthetic Heart Valves: Method Validation by Comparative Heart Valve Calcification Testing.

Nicole Kiesendahl, Christoph Schmitz, Lars Peters, Marek Weiler, Thomas Schmitz-Rode, Ulrich Steinseifer, Johanna C Clauser

Abstract readComparative StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Artificial organs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicole KiesendahlDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Aachen, Germany.
Christoph SchmitzDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Aachen, Germany.
Lars PetersInstitute of Crystallography, RWTH Aachen University, Aachen, Germany.ORCID https://orcid.org/0000-0002-4677-850X
Marek WeilerInstitute of Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany.
Thomas Schmitz-RodeInstitute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Aachen, Germany.ORCID https://orcid.org/0000-0002-1181-2165
Ulrich SteinseiferDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Aachen, Germany.
Johanna C ClauserDepartment of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty RWTH Aachen University, Aachen, Germany.ORCID https://orcid.org/0000-0002-9050-2391

Funding

MedtronicRWTH Aachen University,
6 · The paper itself

Abstract

backgroundA major reason for the failure of bioprosthetic heart valves is calcification. Various pretreatment methods are developed to reduce the calcification behavior. The effectiveness of these methods has so far been investigated in expensive and time-consuming large animal studies. To provide a cost-effective, animal- and possibly also time-saving method, we developed an accelerated dynamic in vitro calcification test method.

methodsWe validated this method using a comparative study of two differently pretreated groups of porcine heart valve bioprostheses. Each group contained N = 4 identical aortic bioprostheses. Calcification onsets, progression, and extent were detected by high-speed video (HSV) documentation and microscopy. Structural identification of the deposits was carried out by X-ray powder diffraction (XRD). Semi-destructive quantification of the calcifications was done by μ-CT as well as destructive chemical quantification via colorimetry and complexometry. The histomorphologic localization of the calcifications was examined by von Kossa staining.

resultsStructural analysis of the deposits indicated "biological apatite" for both test groups. Histological examination revealed localization of the calcifications in the spongiosa zone of the cusps. Quantification of the calcifications showed a distinctly stronger calcification tendency of the No-T6 compared to the anti-calcifying pretreated T6 bioprostheses.

conclusionsWe developed and validated a novel and unique test method for in vitro calcification assessment. The quantitative calcification tendencies of the two test groups are comparable with the results of an in vivo study in sheep. The structural findings are in line with published in vivo observations. The histomorphological localization appears as known for porcine prostheses.

Indexed as

Aortic ValveBioprosthesisCalcinosisHeart Valve ProsthesisMaterials TestingAnimalsProsthesis FailureSwineX-Ray DiffractionX-Ray Microtomographycomparative calcification studycomplexometric Ca quantificationhistomorphologic localization of calcificationshydroxyl apatite (HAP) quantification via μ‐CTstructural identification

Identifiers

PMID41117258
PMCPMC12954470

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