Glutaraldehyde-Fixed Bovine Iliac Veins Used as Bioprosthetic Conduits: An Experimental Animal Study

Abstract

The ideal prosthetic conduit for surgical repair of complex congenital heart disease has yet to be found. Twenty conduits were implanted between the right ventricle and pulmonary artery in growing sheep as follows: four Dacron porcine valve conduits (mean time in place, 142 days); four avalved glutaraldehyde-fixed bovine iliac veins (mean 132 days); and 12 glutaraldehyde-fixed bovine iliac veins containing a porcine valve (mean 180 days). Fifteen conduits were left in place from 167 to 244 days (mean 204 days), and five were explanted earlier (mean 54 days). Pathological study included gross, x-ray, histological, and ultrastructural investigation. Five conduits failed because of infective endocarditis. The valved Dacron conduits showed significant tissue ingrowth and calcification of the valve graft. The valved bovine iliac veins presented calcification at the valve level and vein wall, as well as a valvelike calcific fibrous ridge at the proximal anastomosis with the right ventricle. The avalved bovine iliac veins also presented calcific deposits along the wall and a valvelike calcific ridge at the ventricular anastomosis. Histological and ultrastructural studies of the vein tunica media revealed the phenomena of inflammatory rejection and foreign body reaction with loss of smooth muscle cells (medionecrosis) and fibrotic replacement. In conclusion, bovine iliac veins undergo inflammation with medionecrosis indicating that smooth muscle cell antigenicity is not attenuated by glutaraldehyde fixation.

Macrophage Participation in the Degradation and Remodeling of Extracellular Matrix Scaffolds

“…A common approach for increasing the strength of biologic scaffolds composed of ECM or components of ECM (e.g., purified type I collagen) has been the use of chemical crosslinking agents such as CDI, 24,[32][33][34] isocyanate, 49 or glutaraldehyde. [50][51][52] While chemical crosslinking does maintain the mechanical strength of the scaffold, it also necessarily alters the kinetics of degradation and has a deleterious effect on the biologic activity of the degradation products. The present study showed that CDI effectively inhibited ECM scaffold degradation regardless of the presence of macrophages.…”

A Modified Human Ureter Graft Tanned by a New Crosslinking Agent Polyepoxy Compound for Small Diameter Arterial Substitutions: An Experimental Preliminary Study

“…Although previous reports have demonstrated a vascular xenograft crosslinked with glutaraldehyde in the reconstruction of small caliber biological vessels, such side effects as degeneration, aneurysm formation, and cytotoxicity related to use of glutaraldehyde have remained clinical problems ( 7–9). Recently, however, a polyepoxy compound has been introduced as a new crosslinking agent to overcome the aforementioned disadvantages of glutaraldehyde ( 9–12).…”

“…The glutaraldehyde solution itself is known to have possible genetic side effects. Additionally, the development of ectopic calcification and the tendency to make tissue less flexible, more hydrophobic, and less adaptable to the host tissue, as well as aneurysm formation and cytotoxicity, have all been implicated in the use of glutaraldehyde as a fixative agent ( 7, 8). To overcome these disadvantages, polyepoxy compounds have been introduced as new crosslinking agents and have been found to be more suitable for this purpose than glutaraldehyde ( 9–12).…”

Successful implantation of a decellularized equine pericardial patch into the systemic circulation

“…Besides autologous pericardium, which is often unavailable due to previous operations, implants used are made of synthetic materials such as Dacron (based on Polyethylenterephtalate) or Gore-Tex (based on polytetrafluoroethylene) and biological materials like glutaraldehyde-fixed bovine pericardium [3,4]. A limitation of these implants is that they are permanent foreign bodies with the potential for infection and the absence of remodeling, regeneration, and growth potential [5,6]. Furthermore, the glutaraldehyde-treated material shows early deterioration and should ideally be avoided in young patients [7].…”