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The use of glutaraldehyde-treated biological tissue in heart valve substitutes is an important option in the treatment of heart valve disease. These devices have limited durability, in part, because of tissue calcification and subsequent tearing of the valve leaflets. Components thought to induce calcification include lipids, cell remnants, and residual glutaraldehyde. We hypothesized that treatment of glutaraldehyde-treated bioprosthetic heart valve material using a short and long chain alcohol (LCA) combination, composed of 5% 1,2-octanediol in an ethanolic buffered solution, would reduce phospholipid content and subsequently lower the propensity of these tissues to calcify in vivo. Phospholipid content of glutaraldehyde-treated porcine valve leaflets and bovine pericardium was found to be 10.1 +/- 4.3 (n = 7) and 3.9 +/- 0.48 (n = 2) microg/mg dry tissue, respectively, which was reduced to 0.041 +/- 0.06 (n = 7) and 0.21 +/- 0.05 (n = 4) microg/mg dry tissue, respectively, after LCA treatment. Calcification potential of the treated tissues was assessed using a rat subcutaneous implant model. After 60 days of implantation, calcium levels were found to be 171 +/- 32 (n = 11) and 83 +/- 70 (n = 12) mg/g dry weight for glutaraldehyde-treated porcine leaflets and bovine pericardium, respectively, whereas prior LCA treatment resulted in reduced calcium levels of 1.1 +/- 0.6 (n = 12) and 0.82 +/- 0.1 (n = 12) mg/g dry weight, respectively. These data, taken together, support the notion that treatment of glutaraldehyde-treated tissue with a short and long chain alcohol combination will reduce both extractable phospholipids and the propensity for in vivo calcification.

A new approach for the replacement of heart valves consists of obtaining an acellular matrix from animal aortic valves that performs mechanically, is nonantigenic, and is free from calcification and fibroblast proliferation. Novel biochemical treatments must be developed for this purpose. In this work, we focus on the characterization of collagen in acellular bovine cardiovascular tissues, fresh or glutaraldehyde treated, and stored in different solutions [phosphate-buffered saline (PBS), ethanol, octanol, and glutaraldehyde], to determine whether the resulting fibrous material is structurally preserved. The preservation of the triple helical structure of collagen is checked by differential scanning calorimetry (DSC), which is a well suited technique to analyze thermal transitions in proteins, such as denaturation. To get insight into the molecular dynamics of collagen in the nanometric range, we used thermally stimulated currents, a dielectric technique running at low frequency, that measure the dipolar reorientations in proteins submitted to a static electrical field. The combined use of these two techniques allowed us to evaluate the physical structure and conformation of collagen after the different chemical treatments. We have found that the glutaraldehyde treatment followed by octanol storage preserves the triple helical conformation of the polypeptidic chains of collagen, contrary to the ethanol and PBS storage that induce drastic changes in the thermal and dielectric behavior of the protein. Moreover, this particular chemical treatment stabilizes the collagen structure (shift toward high temperature of the collagen denaturation and stiffening of the chains by a cross-linking action) when compared to the control sample, and so could provide interesting fibrous material for the conception of bioprosthetic heart valve.

Bovine pericardial and porcine valve materials stabilized by dye-mediated photooxidation have shown potential for bioprosthetic valve use. Previously, in vitro and in vivo stability of these materials was demonstrated through enzymatic, chemical, extraction, rat subcutaneous, and functional challenges. Here, we examine the stability of photooxidized porcine aortic valves through amino acid, crosslink, and hydrothermal isometric tension analysis. Photooxidation reduced intact histidine residues from 17.0 to 0 residues per 1000, indicating the photooxidative alteration of this amino acid. Diphenyl borinic acid-derivitized hydrolyzates of proteins were separated by high-performance liquid chromatography, which identified several amino acid crosslinks that appeared with photooxidation that were absent in untreated controls. Thermal relaxation analysis indicated a significantly higher (p < 0.0002) thermal stability for photooxidized porcine cusps than that of untreated controls, with mean relaxation times for untreated cusps of 14,000 +/- 4650 versus 22,900 +/- 2480 s for photooxidized cusps. In summary, porcine aortic valve tissue treated by dye-mediated photooxidation contains new chemical species and exhibits properties consistent with intermolecular crosslink formation, which explain the increased biostability of this material and its potential for use in bioprosthetic devices.