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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Giugno;41(3):341-8

lingua: Inglese

Kangaroo versus porcine aortic valve tissue - Valve geometry morphology, tensile strength and calcification potential

Neethling W. M. L., Papadimitriou J. M. *, Swarts E. **, Hodge A. J. ***

From the Depart­ment of ­Cardio-tho­racic Sur­gery Uni­ver­sity of the ­Free ­State, Bloem­fontein, ­South ­Africa and the Depart­ments of ­Pathology* Med­ical ­Physics** and Cardio-tho­racic Sur­gery*** Royal ­Perth Hos­pital, ­Perth, ­Western Aus­tralia


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Objec­tive. ­Valve ­related fac­tors and ­patient ­related fac­tors are respon­sible for cal­cifi­ca­tion of val­vular bio­pros­theses. ­Recent ­studies ­showed dif­ferent ­donor and recip­ient spe­cies ­have dif­ferent influ­ences on the ­total cal­cifi­ca­tion ­rate of bio­pros­theses. ­This ­study was per­formed to eval­uate and com­pare Kan­garoo ­aortic ­valve leaf­lets ­with por­cine ­aortic ­valve leaf­lets. Experi­mental ­design. Pros­pec­tive ­study. Set­ting. ­Cardio-tho­racic experi­mental ­research of a uni­ver­sity depart­ment.
Mate­rials and ­methods. Glu­ta­ral­de­hyde-­fixed Kan­garoo and por­cine ­valve leaf­lets ­were eval­u­ated in ­vitro ­according to ­valve geom­etry (­internal diam­eter and ­leaflet thick­ness), mor­phology (­light and elec­tron micros­copy) and ten­sile ­strength. In ­vivo eval­u­a­tion con­sisted of implan­ta­tion in a rat ­model for 8 ­weeks, Von ­Kossa ­stain for cal­cium and ­atomic absorp­tion spec­tro­pho­tom­etry for ­total extract­able cal­cium con­tent.
­Results. Kan­garoo ­valves indi­cated a ­smaller ­internal ­valve diam­eter as ­well as a ­thinner ­valve ­leaflet (p<0.01, ­ANOVA) at cor­re­sponding ­body ­weight, ­less pro­te­og­lycan spic­ules in the ­fibrosa, ­increased elas­ticity (p<0.05) and low cal­cifi­ca­tion poten­tial (p<0.01, con­fi­dence ­interval 95%).
Con­clu­sions. Kan­garoo ­aortic ­valve leaf­lets ­have dif­ferent val­vular qual­ities com­pared to por­cine ­valve ­tissue. Kan­garoo ­valve leaf­lets are sig­nif­i­cantly ­superior to por­cine ­valve leaf­lets as far as cal­cifi­ca­tion is con­cerned. ­These ­results are encour­aging and sug­gest fur­ther in ­vivo eval­u­a­tion in a ­larger ­animal ­model ­before clin­ical appli­ca­tion can be con­sid­ered.

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