Heart valve diseases are among the most important challenges in cardiovascular biomaterial design. There are two main types of heart valves - those constructed with metallic components and those made from animal tissue, mainly from bovine pericardium. The clinical usage of bioprosthetic heart valves is limited due to calcification; the result of large hydroxyapatite deposits impeding the leaflet motion which results in valve degeneration and leaflet tearing. The use of biological materials in the construction of bioprostheses requires the application of different chemical procedures to improve the durability of the material without producing any undesirable effects. Chemical crosslinking has been used as a method of stabilising biomaterials for implantation for many years.

A recent report by the American Health Society described a study that investigated the properties of crosslinked versus non-crosslinked materials. The research involved utilising bovine pericardium to ascertain the innate qualities and differences between the duplicate pericardium materials. The study found that crosslinked biological material exhibited greater stiffness, which is an important measure due to the 'stiffness' of the biological material directly correlating with the amount of force the material can withstand as it is deformed or stretched. The study further highlighted the successful application of crosslinked pericardium to the clinical outcomes involving patients suffering from hernias.

Further research has shown that crosslinking pericardium is advantageous to biological implants. Biological implants which are not crosslinked have been shown to be resorbed quickly and do not provide protection against enzyme attack, thus absorbing extremely rapidly in the presence of low grade infections. Furthermore, as crosslinking functions to cap immunogenic epitopes on the collagen molecules, non-crosslinked products also have increased immunogenic potential over their crosslinked counterparts.

An implant material provides strength and structure to the region of repair while the host cells infiltrate, thus enabling gradual ingrowth to the scaffold. The process of remodelling in a crosslinked biological implant, while gradual, is often ordered and organised, resulting in organised host collagen deposition. The use of a crosslinking agent enables control over the wound repair and remodelling process and the rate of this process can be modified by alteration of the level of crosslinking. Without crosslinking, there is no control of the process and therefore the implant scaffold may fail in its function if remodelling occurs too rapidly or in a poorly organised manner.