Calcification characteristics of porcine stented valves in a juvenile sheep model

Flameng, Willem; Ozaki, Shigeyuki; Yperman, Jessa; Herijgers, Paul; Meuris, Bart; Verbeken, Erik

doi:10.1016/s0003-4975(01)02527-9

Cited by 21 publications

(15 citation statements)

References 9 publications

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“…Host metabolism and reaction to foreign material, tissue structure, mechanical stress, and valve processing [2,[5][6][7][8] have all been claimed to play a role in tissue valve calcification, which may be either intrinsic or extrinsic to cuspal tissue, and in structural tissue derangement, which may be independent from calcium deposition. Thus far, all researchers have addressed this specific issue and the above-mentioned factors potentially responsible for postoperative valve failure by working on different kinds of valve design or pre-implant tissue treatment to reduce or avoid postoperative degeneration [2,[9][10][11][12][13][14][15]. Strategies to prevent tissue calcification, inhibitors of hydroxyapatite formation, calcium diffusion inhibitors, peculiar material processing methods to reduce tissue material to calcification, and improved glutaraldehyde or non-glutaraldehyde tissue fixation have been variably investigated and proposed [2], but no approach or medical therapy, to our knowledge, has focused on post-implant treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Biological prostheses today offer a reliable and effective International Journal of Cardiology 141 (2010) 68 -74 www.elsevier.com/locate/ijcard solution for valve replacement to treat cardiac native valve dysfunction without the need for anticoagulation and better hemodynamics as compared to mechanical substitutes. Postoperative tissue degeneration, however, remains a critical issue and represents the most frequent cause of reoperation [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Several agents or new tissueprocessing techniques have been variably applied during tissue valve manufacturing and proposed to reduce or prevent tissue degeneration, but no postoperative therapy has been specifically and prospectively investigated to counteract biological tissue derangement, calcification and inflammation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Atorvastatin attenuates post-implant tissue degeneration of cardiac prosthetic valve bovine pericardial tissue in a subcutaneous animal model

Lorusso

Corradi

Maestri

et al. 2010

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Atorvastatin attenuates post-implant tissue degeneration of cardiac prosthetic valve bovine pericardial tissue in a subcutaneous animal model

Lorusso

Corradi

Maestri

et al. 2010

International Journal of Cardiology

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“…Foram usados também bezerros e suínos para este propósito (6,7) e em ovinos por vários autores (8)(9)(10)(11)(12)(13)(14) , mostrando que estes são os animais de grande porte mais usados para estudos experimentais.…”

Section: Animalunclassified

Implante de tubo valvulado bioprótese "stentless" em posição aórtica: estudo experimental em ovinos

Santos¹,

Gerola²,

Pessa³

et al. 2002

Rev Bras Cir Cardiovasc

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E -Implante de tubo valvulado bioprótese "stentless" em posição aórtica: estudo experimental em ovinos. Rev Bras Cir Cardiovasc 2002; 17(1): 90-8. INTRODUÇÃOO tratamento das lesões valvares representa um grande desafio dentro da cirurgia cardiovascular, pois, até os dias atuais, não temos um substituto ideal para as valvas do coração.Ao contrário das lesões da valva mitral, em que é possível realizar procedimentos conservad o r e s , a t u a n d o -s e e m t o d a s a s e s t r u t u r a s RESUMO: Introdução: O tratamento das lesões valvares representa um grande desafio dentro da cirurgia cardiovascular, pois, até os dias atuais, não temos um substituto ideal para as valvas do coração. As próteses atualmente disponíveis apresentam vantagens e desvantagens; as mecânicas exigem anticoagulação definitiva e as biológicas apresentam baixa durabilidade. Para se chegar a um substituto ideal, são necessárias várias fases, desde a escolha e o preparo do material até o implante em animal de grande porte. Esta última é muito importante, pois a escolha do animal deve ser criteriosa. Ovinos juvenís são animais dóceis de fácil manipulação e suas características anatômicas e biológicas se assemelham muito ao que ocorre com o ser humano e as próteses "stentless" são substitutos mais próximos dos homoenxertos.Material e Método: Foram operados 30 ovinos juvenís com idade variando de 4,4 a 6,3 meses, peso de 25 a 37 kg, sendo 28 machos. Todos os animais foram submetidos a circulação extracorpórea para implante de bioprótese "stentless" montada em tubo de aorta porcina, com reimplante de artérias coronárias. A operação foi realizada com hipotermia moderada e cardioplegia gelada. O período de seguimento foi de 30 dias e, ao final, realizado ecocardiograma.Resultados: Houve 8 (26,6%) óbitos no intra-operatório e 6 (27,7%) óbitos no seguimento. O tempo médio de CEC foi de 98 min. Foi realizado ecocardiograma em 16 animais e em nenhum caso foram vistos sinais de endocardite ou outras alterações; a fração média de ejeção foi de 74%.Conclusão: Este modelo experimental utilizando ovinos para o estudo de biopróteses "stentless" em posição aórtica mostrou-se bem reprodutível e a performance do enxerto bastante factível de ser avaliada, pois ovinos são animais dóceis e de fácil manipulação no seguimento tardio. DESCRITORES: Valva aórtica, cirurgia. Implantle de prótese vascular. Biopróteses.RBCCV anatômicas desde o anel valvar até os múscu-los papilares; a valva aórtica possui estrutura anatômica mais simples, onde os procedimentos conservadores são menos variados e com resultados pouco satisfatórios quando comparados com as plastias realizadas na valva mitral. Por esta razão, com raras exceções, o tratamento das lesões severas da valva aórtica, quase sempre, representa a troca da mesma.

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“…Glutaraldehyde crosslinking is generally used in xenogenic bioprotheses to make connective tissue matrices resistant to degeneration and to reduce antigenicity. Flameng et al [10] showed that in general there is an important difference between leafl et and wall calcifi cation in commercially available bioprostheses. The anticalcifi cation treatments normally achieved good results at the level of the leafl ets, however at the wall, strong structural deterioration is seen.…”

Section: Discussionmentioning

confidence: 99%

Is There a Possibility for a Glutaraldehyde-Free Porcine Heart Valve to Grow?

et al. 2006

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Objective: A challenging issue is to create a heart valve with growth and remodeling potential, which would be of great interest for congenital heart valve surgery. This study was performed to evaluate the growth and remodeling potentials of a decellularized heart valve. Methods: In 4 juvenile sheep (age 12 ± 1 weeks) with a weight of 24.3 ± 4.4 kg, a 17-mm diameter decellularized porcine valve was implanted as pulmonary valve replacement. Valve growth was evaluated by transthoracic echocardiography. At explantation, valves were evaluated by gross examination, light microscopy (hematoxylin and eosin, von Kossa, Sirius red, Weigert and Gomori staining), electron microscopy and immunohistochemistry. Atomic absorption spectrometry was performed to evaluate calcium content. Results: All animals showed fast recovery. The mean follow-up was 9.0 ± 1.8 months. All sheep at least doubled their weight (54.3 ± 9.2 kg). Echocardiography showed no regurgitation and a flow velocity of 0.7 ± 0.1 m/s at the latest follow-up. The valve diameter increased from 17.6 ± 0.5 to 27.5 ± 2.1 mm (p < 0.018). Gross examination showed a similar wall thickness of the implanted valve and native pulmonary wall, with smooth and pliable leaflets. Histology showed a monolayer of endothelial cells, fibroblast ingrowth and production of new collagen. No calcification was seen at von Kossa staining, confirmed by low calcium content levels of the valve wall and leaflets at atomic absorption spectrometry. Conclusions: This glutaraldehyde-free heart valve showed not only the absence of calcification, but also remodeling and growth potential.

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Calcification characteristics of porcine stented valves in a juvenile sheep model

Cited by 21 publications

References 9 publications

Atorvastatin attenuates post-implant tissue degeneration of cardiac prosthetic valve bovine pericardial tissue in a subcutaneous animal model

Atorvastatin attenuates post-implant tissue degeneration of cardiac prosthetic valve bovine pericardial tissue in a subcutaneous animal model

Implante de tubo valvulado bioprótese "stentless" em posição aórtica: estudo experimental em ovinos

Is There a Possibility for a Glutaraldehyde-Free Porcine Heart Valve to Grow?

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