Comparison of different anticalcification treatments for stentless bioprostheses

Walther, Thomas; Falk, Volkmar; Autschbach, Rüdiger; Diegeler, Anno; Rauch, T.; Weigl, Claudia; Günther, B; Son, Jacques A.M. van; Mohr, Friedrich W.

doi:10.1016/s0003-4975(98)00985-0

Cited by 20 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…17 A significant reduction of tissue calcification has been shown on animal experiments for the aminooleic acid and XenoLogiX treatments. 18,19 Surgery was performed by experienced surgeons only via standard median sternotomy. Extracorporeal circulation was initiated by right atrial and ascending aorta cannulation.…”

Section: Methodsmentioning

confidence: 99%

Prospectively Randomized Evaluation of Stented Xenograft Hemodynamic Function in the Aortic Position

et al. 2004

Self Cite

View full text Add to dashboard Cite

Background-Standard stented aortic xenograft valves have not yet been compared regarding their hemodynamic function using a stratified intraoperative randomization protocol. Methods and Results-100 patients were prospectively included after intraoperative metric sizing of the decalcified aortic annulus. They received Mosaic (M) or Perimount (P) aortic valve replacement. Patient age was 73Ϯ5 years, 51 were female, and New York Heart Association (NYHA) functional class was 2.8Ϯ0.5. The 21-mm annulus group consisted of 5 (M)/7 (P) patients, the 23-mm annulus group of 20 (M)/20 (P), the 25-mm annulus group of 18 (M)/19 (P), and the 27-mm annulus group of 4 (M)/7 (P) patients, respectively. Hemodynamic function was evaluated using transthoracic echocardiography before discharge and at follow-up (438Ϯ352 days). Surgery was uncomplicated in all patients. Labeled valve sizes were 0.93 (M) and 1.05 (P) mm smaller than the annulus diameters (pϭNS). In-hospital mortality was 5%, all nonvalve-related. Transvalvular blood flow velocities and transvalvular pressure gradients were significantly lower in the 25 P versus the 25 M group at baseline and in the 23 P and 25 P groups at follow-up. There was a significant regression of left ventricular mass index in all patients at follow-up. However, left ventricular mass regression was more pronounced after P aortic valve replacement. Conclusion-Labeled sizes of prosthetic heart valves implanted are smaller than the true aortic annulus. Both standard aortic xenografts compared in this prospectively randomized trial provide a sufficient hemodynamic and functional outcome.

show abstract

Section: Methodsmentioning

confidence: 99%

Prospectively Randomized Evaluation of Stented Xenograft Hemodynamic Function in the Aortic Position

et al. 2004

Self Cite

View full text Add to dashboard Cite

show abstract

“…Nowadays, all new anticalcificant treatments aim at washing residual GA out; thereafter, either additional surfactants are applied or methods to block calcification at the cellular level or to extract cells are used [6] [10]. At present, not all details of the different treatments are fully disclosed.…”

Section: Commentsmentioning

confidence: 99%

“…Despite the controversies around the different effects of GA on the calcification process [4] [5], GA-fixed tissue remains the basic concept of xenograft engineering and GA is the standard fixative with no alternative in view. Nevertheless, additional anticalcificant treatments have been developed to block calcification at the cellular level and to provide better structural integrity [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Does the Animal Origin Influence the Calcification of Xenograft Tissue Heart Valve Substitutes? Comparison between Bovine and Camel Pericardium in a Subcutaneous Rat Model

Harmoodi¹,

Shafy²,

Guichardant³

et al. 2015

IJCM

View full text Add to dashboard Cite

Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± * Corresponding author. F. Al Harmoodi et al. 7010.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns); collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.

show abstract

“…Die Segel der Mosaic ® -Klappe werden mit der so genannten "Root Pressure"-Technik fixiert [1,22,23], die Antikalzifikiationsbehandlung erfolgt mit Aminoölsäure (AOA ® ) [9,25] Table 3). The freedom from prosthesis-related event rates, calculated according to Kaplan-Meier, at 5 years were: 97.3 ± 1.9% for permanent neurological, 99.0 ± 1.0% for transient neurological, 95.9 ± 3.2% for thrombosed prosthesis, 95.6 ± 2.2% for antithromboembolic related hemorrhage, 96.2 ± 3.7% for structural valve deterioration, 96.9 ± 3.0% for non-structural dysfunction, 100% for endocarditis and 92.0 ± 4.9% for explant (see Table 4).…”

Section: The Mosaic® Bioprosthesis At 5 Years Abstractmentioning

confidence: 99%

“…AOA ® bindet kovalent an die freien Aldehydgruppen des Glutaraldehyds unter Bildung einer Schiff'schen Base. AOA ® verzögert die Calciumdiffusion in das Gewebe und reduziert die Bildung von Calciumphosphatkristallen [2,25].…”

Section: Diskussionunclassified

Mosaic®-Bioprothese nach fünf Jahren

Eichinger

Günzinger²,

Botzenhardt³

et al. 2000

Herz

View full text Add to dashboard Cite

The Mosaic bioprosthesis is a stented porcine aortic valve, which combines the zero pressure differential fixation technique (by applying equal pressure to the in- and outflow ends of the valve, the aortic root is pressurized to maximize the flow area while no pressure is exerted on the leaflets) and an antimineralization treatment with alpha amino oleic acid for improved tissue durability. The device is in clinical use since February 1994. The purpose of this study was to collect intermediate term data of the Mosaic bioprosthesis in the aortic position to evaluate its clinical and hemodynamic function. From February 1994 to May 1999, 100 patients underwent aortic valve replacement with the Mosaic prosthesis at our department. There were 49 female patients, mean age at implant was 73.4 +/- 7.3 years (range 31 to 87). Concomitant procedures were done in 40%. Preoperative and operative clinical data are shown in Tables 1 and 2. When assessing the size of the bioprosthesis, it is important to use the original Mosaic sizer. Because of the possibility of the so-called supra-x placement, the specific construction of the sizer and the Mosaic valve often allow the implantation of a 1-size larger valve compared to the conventional supra-annular placement. By this a significant increase in the effective flow orifice is possible. This proceeding is depicted in Figure 1. All patients have been anticoagulated with phenprocoumon at least for 3 months postoperatively, INR was aimed at 2.5 to 3.5. Patients have been followed up prospectively, within the initial hospitalization for valve replacement, 6 months postoperatively and at annual intervals including an hematological check and transthoracic echocardiography. The mean follow-up was 2.7 years with a total follow-up of 273.7 patient years. The follow-up was 100% complete. After 5 years the mean systolic pressure gradient was 15.2 +/- 3.0 mm Hg for the 21-mm, 13.1 +/- 4.6 mm Hg for the 23-mm, 10.0 +/- 3.1 mm Hg for the 25-mm valve size, the effective orifice area 1.6 +/- 0.3 cm2 (21-mm), 1.9 +/- 0.3 cm2 (23-mm) and 2.5 +/- 0.8 cm2 (25-mm) (see Table 3). The freedom from prosthesis-related event rates, calculated according to Kaplan-Meier, at 5 years were: 97.3 +/- 1.9% for permanent neurological, 99.0 +/- 1.0% for transient neurological, 95.9 +/- 3.2% for thrombosed prosthesis, 95.6 +/- 2.2% for antithromboembolic related hemorrhage, 96.2 +/- 3.7% for structural valve deterioration, 96.9 +/- 3.0% for non-structural dysfunction, 100% for endocarditis and 92.0 +/- 4.9% for explant (see Table 4). The total operative mortality (within 30 days) was 3.0%, the late postoperative mortality was 4.4% per patient year and included a valve related mortality rate of 0.7%/patient year. In Figure 2 the survival function after aortic valve replacement is depicted, arranged in freedom from all deaths, from Mosaic-related deaths and from Mosaic-related plus sudden/unexplained deaths. Before implantation of the Mosaic bioprosthesis 95% of the patients were in NYHA Classes III and IV, whereas 6 ...

show abstract

Comparison of different anticalcification treatments for stentless bioprostheses

Cited by 20 publications

References 13 publications

Prospectively Randomized Evaluation of Stented Xenograft Hemodynamic Function in the Aortic Position

Prospectively Randomized Evaluation of Stented Xenograft Hemodynamic Function in the Aortic Position

Does the Animal Origin Influence the Calcification of Xenograft Tissue Heart Valve Substitutes? Comparison between Bovine and Camel Pericardium in a Subcutaneous Rat Model

Mosaic®-Bioprothese nach fünf Jahren

Contact Info

Product

Resources

About