Viability of fresh aortic valve homografts: a quantitative assessment

Abstract

Accumulated evidence indicates that fresh aortic valve homografts function longer than preserved grafts. Thus it becomes important to assess the viability of fresh homografts on a quantitative basis. Recently, we have used autoradiography in addition to tissue culture to determine the viability of fresh aortic and pulmonary valve homografts. The uptake of thymidine was gradually reduced to 50% after 18 days of preservation in a balanced salt solution with antibiotics and the uptake was reduced to 21 % in 63 days. We think that a nutrient medium is necessary if longer viability is to be obtained.

Pathology of antibiotic-treated human heart valve allografts

“…While it is known that chemical sterilization destroys donor cells (Hudson, 1966;Smith, 1967;Gavin et al, 1972), it has been suggested that a milder form of sterilization using antibiotics may preserve the viability of donor fibroblasts (Angell, Mermet, and Buch, 1970; Al-Janabi, Gonzalez-Lavin, Neirotti, and Ross, 1972), as has been reported in fresh unsterilized grafts (Mohri, Reichenbach, Barnes, and Merendino, 1968;Kosek, Iben, Shumway, and Angell, 1969), and that this may be the basis for the improved results with antibiotic-treated allografts. However, prolonged survival of donor cells within the recipient does not follow storage of allografts in antibiotics at the concentrations and for the intervals used for the material studied, although degenerate but light-microscopically normal fibroblasts were often present at the time of insertion.…”

Fascia lata valves: a clinicopathological study.

“…Even slightly irregular suturing, or placing sutures too tightly on the frame-mounted valve leaflets, would accelerate valve failure. Repetitive trauma and failure to consider shrinkage of fascia lata, estimated to be in the region of 30%, has been suggested as a cause of valve dysfunction by Bailey et al (1973). These authors consider fascia lata to be the best available autologous tissue.…”

“…Even in the aortic position, evidence is now accumulating that failure of satisfactory valve function does eventually take place in a considerable number of patients (Senning and Rothlin, 1973 Viability studies were carried out on two valves. This was assessed quantitatively using auto radiography and the utilization of methyltritiated thymidine (Al-Janabi et al, 1972). After placing strips of fascia lata in nutrient medium (199+10% calf serum), 5% methyl-tritiated thymidine was added.…”

Viability of fresh mitral homograft valves

“…This may be related in some measure to the fact that the chordae lack living cells. As it has become clear that the long-term function of aortic homograft valves relates to the methods of sterilization and storage used (Hudson, 1966;Smith, 1967;Davies et al, 1968) storage in antibiotic and nutrient media could be advantageous for the mitral valves also.This paper records an attempt to measure and compare the viability of the mitral leaflet, chordae, and papillary muscle using an autoradiographic technique already described (Al-Janabi, Gonzalez-Lavin, Neirotti, and Ross, 1972). …”

“…This paper records an attempt to measure and compare the viability of the mitral leaflet, chordae, and papillary muscle using an autoradiographic technique already described (Al-Janabi, Gonzalez-Lavin, Neirotti, and Ross, 1972).…”