Controversial and unresolved issues in the classification of surgically implanted biological heart valve prostheses (problem lecture)

One of the significant areas of cardiac surgery is the replacement of damaged or faulty heart valves. Biological heart valve prostheses created from biological tissues represent a significant achievement in this area, providing effective treatment and improving the quality of life of patients. Aim: To analyze and discuss unresolved issues in the classification of surgically implanted biological heart valve prostheses. Various approaches to the classification of biological heart valve prostheses are presented, including from the standpoint of their historicity. Particular attention is paid to the prospects for the development of combined technologies in the creation of heart valve prostheses. Thus, the rapid development of biological and engineering technologies makes significant adjustments to the very concept of “biological heart valve prosthesis”. A transformation in the production of these medical devices is expected, which is already associated with the development and implementation of bioengineering technologies in clinical practice, which may lead to the abandonment of existing methods of production and use of biopolymers (collection from animals and fixation /sterilization /storage in glutaraldehyde or a similar agent). It is obvious that in the near future, synthetic, combined bioprostheses and valves created on the basis of promising tissue engineering technologies will appear. Innovative tissue and cell prostheses already include structures created from patient cells or using bioprinting. In general, these technologies are aimed at creating prostheses that can have an ideal match to the patient's anatomy and minimize the risk of rejection. Such valves are likely to be stronger, less likely to cause complications and easier to implant.