Stentless Valves Treated by the L-Hydro Process in the Aortic Position in Sheep

Santos, Paulo Caleb Júnior Lima; Gerola, Luís Roberto; Casagrande, Ivan S. J.; Buffolo, Ênio; Cheung, David T.

doi:10.1177/021849230701500511

Cited by 2 publications

(4 citation statements)

References 18 publications

(16 reference statements)

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“…Likewise, the example of these studies, macroscopic and microscopic evaluation showed a greater degree of calcification in bioprostheses preserved in glutaraldehyde. In relation to microscopy, the results show higher calcification of glutaraldehyde preserved grafts, as well as studies Nina et al [22] and Santos et al [23]. In the case of prostheses preserved in L-Hydro R , Nina et al [22], observed by scanning electron microscopy, the formation of a new endothelium-resistant exudation of plasma proteins and salts, which are precursors of bioprosthetic degeneration.…”

Section: Discussionsupporting

confidence: 74%

Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation

Souza¹,

Palma²,

Casagrande³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Substituição do tronco da artéria pulmonar em carneiros utilizando heteroenxerto tubular valvado com preservação não-aldeídicaReplacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation 8 Abstract Introduction: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses.Objectives: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-Hydro®).Methods: Seventeen sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-Hydro® (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation the animals were sacrificed, necropsied and implants subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%).Results: The radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthetic group Glutaraldehyde, when compared to 420 Souza HJB, et al. -Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation Rev Bras Cir Cardiovasc 2012;27(3):419-28denture-HydroR Group L (P = 0.001). Seven animals in Group L-Hydro® (50%) had adherence of the leaflets to the wall of the tube (P = 0.228).Conclusions: Prostheses preserved in L-Hydro® were more resistant to calcification when compared with glutaraldehyde preserved.Descriptors: Bioprosthesis. Glutaral. Polyethylene glycols. Heart valve prosthesis. Heart valve diseases/surgery.

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Section: Discussionsupporting

confidence: 74%

Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation

Souza¹,

Palma²,

Casagrande³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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“…9 Moreover, multiple applications of cardioplegia has been described by many authors and seems to be more cardioprotective than administering a single dose. 1,6,17,19,21 We observed that inducing complete cardiac arrest throughout surgery by administering multiple doses of cardioplegia and by giving a final dose immediately before declamping the aorta protects the myocardium and promotes spontaneous recovery to a stable sinus rhythm.…”

Section: Discussionmentioning

confidence: 99%

“…19 Consequently, high on-table mortality rates, ranging from 9% to 33%, have been reported. 1,18,21,24 Furthermore, the incidence of mortality during the first 30 d after surgery, directly related to the surgical procedure, is often high, ranging from 17% to 50%. 1,2,16,18,21 Therefore, optimizing cardioprotective strategies during surgery would improve postoperative survival.…”

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Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

et al. 2021

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Sheep are a commonly used and validated model for cardiovascular research and, more specifically, for heart valve research.Implanting a heart valve on the arrested heart in sheep is complex and is often complicated by difficulties in restarting the heart, causing significant on-table mortality. Therefore, optimal cardioprotective management during heart valve implantation in sheep is essential. However, little is known about successful cardioprotective management techniques in sheep. This article reports our experience in the cardioprotective management of 20 female sheep that underwent surgical aortic valve replacement with a stented tissue-engineered heart valve prosthesis. During this series of experiments, we modified our cardioprotection protocol to improve survival. We emphasize the importance of total body hypothermia and external cooling of the heart. Furthermore, we recommend repeated cardioplegia administration at 20 min intervals during surgery, with the final dosage of cardioplegia given immediately before the de-clamping of the aorta. To reduce the number of defibrillator shocks during a state of ventricular fibrillation (VF), we have learned to restart the heart by reclamping the aorta, administeringcardioplegia until cardiac arrest, and de-clamping the aorta thereafter. Despite these encouraging results, more researchis needed to finalize a protocol for this procedure.

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Stentless Valves Treated by the L-Hydro Process in the Aortic Position in Sheep

Cited by 2 publications

References 18 publications

Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation

Replacement of pulmonary artery trunk in sheep using tubular valved heterograft in non-aldehydic preservation

Strategies to Improve Survival from Surgery for Heart Valve Implantation in Sheep

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