Grant: Doctoral Research Award: Canada Graduate Scholarships

BACKGROUND One of the most common forms of heart disease is heart valve disease (HVD). By reducing our hearts' ability to pump blood through our bodies, HVD is often fatal. Unfortunately, there is no medication to slow or prevent HVD, so the main treatment option is replacing the diseased valves with bioprosthetic heart valves (BPHVs), artificial valves made from animal tissue. However, BPHVs degenerate and usually fail within 10-15 years, making durability a pressing issue. A major barrier to improving BPHV durability is our limited understanding of how and why degeneration occurs. An important process that may contribute to degeneration is fibrosis (scar tissue), as fibrosis can stiffen a BPHV, no longer allowing blood to pass through them properly. GOAL This study aims to uncover the nature of BPHV fibrosis and how it impacts BPHV function. APPROACH Tissue staining of our large and unique group of BPHV explants (valves removed from patients) will provide an overview of the types of degeneration. Patient files will be reviewed to identify associated risk factors and establish a timeline of BPHV fibrosis. Molecular stains and cell studies of BPHV explants will define their molecular and cellular landscapes. Benchtop models will be built to simulate the behaviour and development of BPHV fibrosis to help understand and predict specific clinical scenarios. OUTCOMES Unique access to BPHV explants and testing provides an unparalleled resource to answer our research questions. Insights into BPHV fibrosis and BPHV failure could be used to inform clinical decision-making and influence future BPHV designs, improving BPHV durability and reducing failure to improve patient outcomes.