Pathology of the formalin-treated heterograft porcine aortic valve in the mitral position

Rose, Alan G.

doi:10.1136/thx.27.4.401

Cited by 30 publications

(6 citation statements)

References 17 publications

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“…[1][2][3] Historically, to avoid immune-response-related rejection and to stabilize the xenogenic matrix, porcine valves were treated with formaldehyde; although these valves were an improvement over nontreated bioprostheses, they degraded after implantation. 4,5 Subsequently, along with aldehyde-based crosslinking chemistry, glutaraldehyde treatment became the standard process for preserving and stabilizing xenografts for clinical use. [1][2][3] There is a long and successful clinical history of glutaraldehyde-treated bioprosthetic heart-valve use.…”

Section: Introductionmentioning

confidence: 99%

Calcification resistance, biostability, and low immunogenic potential of porcine heart valves modified by dye-mediated photooxidation

Moore

Adams

2001

J. Biomed. Mater. Res.

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The calcification potential, biostability, and immunogenic response of materials intended for long-term in vivo use, such as in heart-valve bioprostheses, are essential components of device performance. Here we explore these properties in photooxidized porcine heart valves. To study immunological sensitization, we injected tissue extracts intradermally into guinea pigs. Test and control animals received a challenge patch of the appropriate extract and were scored for dermal reactions. Neither cottonseed oil nor sodium chloride extracts of photooxidized heart-valve tissues caused any dermal inflammatory response. After implantation in the rat subcutaneous model for 90 days, the calcium content of 48-h-treated photooxidized cusp tissue [0.04 +/- 0.00 mg/g wet weight (gww)] was comparable to that of unimplanted control tissues (usually <1 mg/gww) and much lower than that of glutaraldehyde-treated controls (71 +/- 15 mg/gww). The porcine aortic wall calcium content (49 +/- 31 mg/gww) was comparable to that of glutaraldehyde-treated controls (59 +/- 8 mg/gww). Histologically, a time-dependent decrease in inflammation and vascularization with increasing photooxidation time was noted in the rat model along with an increase in the stability and organization of collagen bundles. In summary, porcine valve tissues treated by dye-mediated photooxidation were resistant to calcification, were biostable, and demonstrated a low immunogenic response, indicating potential for use in heart-valve bioprostheses.

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Section: Introductionmentioning

confidence: 99%

Calcification resistance, biostability, and low immunogenic potential of porcine heart valves modified by dye-mediated photooxidation

Moore

Adams

2001

J. Biomed. Mater. Res.

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“…Few patients have been followed up for more than five years at the present time. While calcification of fresh aortic homograft valves may be a significant problem (Smith, 1967;Davies et al, 1968), this was not encountered with formalin-treated xenografts (Ionescu et al, 1968;Rose, 1972). Roberts (1976) The severe calcification in our patient's xenograft one year after implantation is very disturbing.…”

Section: Discusionmentioning

confidence: 74%

Calcification of glutaraldehyde-fixed porcine xenograft.

Rose

Forman

Bowen

1978

Thorax

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“…Historically, to avoid immune responserelated rejection and to stabilize the xenogenic matrix, valve tissues were treated with formaldehyde, which, although an improvement over nontreated bioprostheses, were found to degrade after implantation. 5,6 Subsequently, and also using aldehyde-based crosslinking chemistry, glutaraldehyde treatment became the standard process in preserving and stabilizing xenografts for clinical use. 1,2 There has been a long and successful clinical history for glutaraldehydetreated bioprosthetic heart valves with this treatment remaining the method of choice and the only proven technology for long-term tissue stabilization.…”

Section: Introductionmentioning

confidence: 99%

Treatment of bioprosthetic heart valve tissue with long chain alcohol solution to lower calcification potential

Pathak¹,

Adams²,

Simpson³

et al. 2004

J Biomedical Materials Res

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The use of glutaraldehyde-treated biological tissue in heart valve substitutes is an important option in the treatment of heart valve disease. These devices have limited durability, in part, because of tissue calcification and subsequent tearing of the valve leaflets. Components thought to induce calcification include lipids, cell remnants, and residual glutaraldehyde. We hypothesized that treatment of glutaraldehyde-treated bioprosthetic heart valve material using a short and long chain alcohol (LCA) combination, composed of 5% 1,2-octanediol in an ethanolic buffered solution, would reduce phospholipid content and subsequently lower the propensity of these tissues to calcify in vivo. Phospholipid content of glutaraldehyde-treated porcine valve leaflets and bovine pericardium was found to be 10.1 +/- 4.3 (n = 7) and 3.9 +/- 0.48 (n = 2) microg/mg dry tissue, respectively, which was reduced to 0.041 +/- 0.06 (n = 7) and 0.21 +/- 0.05 (n = 4) microg/mg dry tissue, respectively, after LCA treatment. Calcification potential of the treated tissues was assessed using a rat subcutaneous implant model. After 60 days of implantation, calcium levels were found to be 171 +/- 32 (n = 11) and 83 +/- 70 (n = 12) mg/g dry weight for glutaraldehyde-treated porcine leaflets and bovine pericardium, respectively, whereas prior LCA treatment resulted in reduced calcium levels of 1.1 +/- 0.6 (n = 12) and 0.82 +/- 0.1 (n = 12) mg/g dry weight, respectively. These data, taken together, support the notion that treatment of glutaraldehyde-treated tissue with a short and long chain alcohol combination will reduce both extractable phospholipids and the propensity for in vivo calcification.

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Pathology of the formalin-treated heterograft porcine aortic valve in the mitral position

Cited by 30 publications

References 17 publications

Calcification resistance, biostability, and low immunogenic potential of porcine heart valves modified by dye-mediated photooxidation

Calcification resistance, biostability, and low immunogenic potential of porcine heart valves modified by dye-mediated photooxidation

Calcification of glutaraldehyde-fixed porcine xenograft.

Treatment of bioprosthetic heart valve tissue with long chain alcohol solution to lower calcification potential

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