What is the issue for NSW?
Aortic stenosis is the abnormal narrowing of the aortic valve which restricts the flow of blood from the heart to the rest of the body. As the most prevalent heart valve disease in Australia, affecting up to 7% of those over 65, aortic stenosis has a three year survival rate of less than 30% if untreated.
Transcatheter aortic valve implantation is a minimally invasive procedure that replaces stenotic valves with new leaflets, or flaps, and is an increasingly common solution following success in older and high-risk patients. The procedure allows earlier intervention with greater benefits to quality of life.
However, extending transcatheter aortic valve implantation benefits to a wider range of patients, including younger and low-risk groups, requires valve leaflets that last longer in the body. Bovine and porcine pericardium leaflets are currently the only materials compatible with transcatheter aortic valve implantation. They are susceptible to accelerated degradation and calcification in these patients, limiting their lifespan to 5-10 years. To avoid unexpected transcatheter aortic valve implantation failures and multiple re-interventions throughout a patient’s lifetime, there is a need for new leaflets that can last as long as possible, ideally for the entirety of the patient’s life.
What does the research aim to do and how?
This project will develop a nanoparticle therapy which can coat pericardium leaflets prior to transcatheter aortic valve implantation to improve their biological resilience, helping to extend the procedures benefits to larger patient cohorts. These nanoparticles can carry therapeutic drugs which can change how the body perceives these devices very early after being implanted. When used as coatings for leaflets, they are strategically designed to have no impact on the mechanical motion of leaflet opening and closing, allowing drug-presentation on transcatheter aortic valve implantation replacement valves for the first time.
The top three key measures/indicators being used to assess the research outcomes are:
- Nanoparticle coatings can be applied to valve leaflets in a simple and cost-effective single-step process
- Nanoparticle coatings actively target the main biological drivers of leaflet failure
- Nanoparticle coatings extend the longevity of implanted transcatheter aortic valve implantation valves