Zwitterionic hydrogel coatings enhance anti-fouling and anti-thrombogenicity of decellularized swim bladder for bioprosthetic heart valves.

Glutaraldehyde cross-linked bovine/porcine pericardium has been used as prosthetic heart valves (BHVs), while residual aldehyde groups induce cytotoxicity, thrombus formation, and progressive calcification deposition, which ultimately limits instrument life span to 10-15 years. We innovatively designed a multifunctional zwitterionic hydrogel coating copolymer poly (SBMA-co-DMEMAm) on swim bladder-derived material, which is composed of hydrophilic monomer SBMA and aldehyde-containing monomer DMEMAm; besides the aldehyde group can crosslink fish bladder tissue and improve the mechanical properties. This multifunctional hydrophilic polymer coatings provide effective anti-fouling properties, better anti-platelet adsorption and anti-thrombotic properties in in vitro blood compatibility evaluation. In addition, it showed better anti-inflammatory and anti-calcification properties in rat subcutaneous implantation. Thus, this study presents a versatile zwitterionic hydrogel coating strategy that simultaneously endows decellularized swim bladder with superior anti-fouling, hemocompatibility, cytocompatibility, and anti-thrombogenicity, offering a comprehensive solution for durable bioprosthetic heart valves.