Homologous dura mater cardiac valves

Puig, Luiz Bóro; G, Verginelli; Iryia, Kiyoshi; Kawabe, L; Bellotti, Giovanni; Sosa, Eugenio Selman-Houssein; Pilleggi, F; Zerbini, E.J.

doi:10.1016/s0022-5223(19)41506-7

Cited by 27 publications

(3 citation statements)

References 14 publications

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“…The dura mater bioprosthesis is associated with low thrombogenicity, but structural deterioration constitutes the main reason for reoperation 14,15 . The main complication was tissue tears, and these were observed after 6 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Dura mater mitral and tricuspid bioprostheses: 30 years of follow-up

et al. 2003

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Section: Discussionmentioning

confidence: 99%

Dura mater mitral and tricuspid bioprostheses: 30 years of follow-up

et al. 2003

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“…[1][2][3][4] Additional successful results in the repair of gingiva, myelomeningoceles, and cardiac valves by using dura mater have also been reported. [5][6][7] A variety of allograft or heterograft tissues have been used in the surgical repair of perforations of the tympanic membrane such as skin, placenta, perichondrium, vein, mucosa, periostium, adipose or connective tissue, temporalis fascia, collagen film, cartilage, peritoneum, bovine intestine, homograft tympanic membrane, and dura mater. 8 Fascia, perichondrium, and dura mater are the most accepted materials for the primary closure of the eardrum perforations.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…The dura grafts have demonstrated excellent tissue tolerance and stability in the surgical management of skeletal, diaphragmatic, esophageal, and abdominal repairs as well as defects of the bladder wall and in reconstruction of orbital floor and ora-antral fistula 1–4 . Additional successful results in the repair of gingiva, myelomeningoceles, and cardiac valves by using dura mater have also been reported 5–7 …”

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confidence: 99%

Revision Myringoplasty with Solvent‐Dehydrated Human Dura Mater (Tutoplast)

Yetışer

Tosun

Satar

2001

Otolaryngol.--head neck surg.

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Tissue heart valves: Current challenges and future research perspectives

Schoen¹,

Levy²

1999

J. Biomed. Mater. Res.

409

216

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Substitute heart valves composed of human or animal tissues have been used since the early 1960s, when aortic valves obtained fresh from human cadavers were transplanted to other individuals as allografts. Today, tissue valves are used in 40% or more of valve replacements worldwide, predominantly as stented porcine aortic valves (PAV) and bovine pericardial valves (BPV) preserved by glutaraldehyde (GLUT) (collectively termed bioprostheses). The principal disadvantage of tissue valves is progressive calcific and noncalcific deterioration, limiting durability. Native heart valves (typified by the aortic valve) are cellular and layered, with regional specializations of the extracellular matrix (ECM). These elements facilitate marked repetitive changes in shape and dimension throughout the cardiac cycle, effective stress transfer to the adjacent aortic wall, and ongoing repair of injury incurred during normal function. Although GLUT bioprostheses mimic natural aortic valve structure (a) their cells are nonviable and thereby incapable of normal turnover or remodeling ECM proteins; (b) their cuspal microstructure is locked into a configuration which is at best characteristic of one phase of the cardiac cycle (usually diastole); and (c) their mechanical properties are markedly different from those of natural aortic valve cusps. Consequently, tissue valves suffer a high rate of progressive and age-dependent structural valve deterioration resulting in stenosis or regurgitation (>50% of PAV overall fail within 10-15 years; the failure rate is nearly 100% in 5 years in those <35 years old but only 10% in 10 years in those >65). Two distinct processes-intrinsic calcification and noncalcific degradation of the ECM-account for structural valve deterioration. Calcification is a direct consequence of the inability of the nonviable cells of the GLUT-preserved tissue to maintain normally low intracellular calcium. Consequently, nucleation of calcium-phosphate crystals occurs at the phospholipid-rich membranes and their remnants. Collagen and elastin also calcify. Tissue valve mineralization has complex host, implant, and mechanical determinants. Noncalcific degradation in the absence of physiological repair mechanisms of the valvular structural matrix is increasingly being appreciated as a critical yet independent mechanism of valve deterioration. These degradation mechanisms are largely rationalized on the basis of the changes to natural valves when they are fabricated into a tissue valve (mentioned above), and the subsequent interactions with the physiologic environment that are induced following implantation. The "Holy Grail" is a nonobstructive, nonthrombogenic tissue valve which will last the lifetime of the patient (and potentially grow in maturing recipients). There is considerable activity in basic research, industrial development, and clinical investigation to improve tissue valves. Particularly exciting in concept, yet early in practice is tissue engineering, a technique in which an anatomically appropriate construct con...

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Homologous dura mater cardiac valves

Cited by 27 publications

References 14 publications

Dura mater mitral and tricuspid bioprostheses: 30 years of follow-up

Dura mater mitral and tricuspid bioprostheses: 30 years of follow-up

Revision Myringoplasty with Solvent‐Dehydrated Human Dura Mater (Tutoplast)

Tissue heart valves: Current challenges and future research perspectives

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