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Chirurgia 2019 December;32(6):313-7

DOI: 10.23736/S0394-9508.18.04940-9


language: English

Sodium bisulfite as an anticalcification treatment for implantable biological tissues

E. Andreas AGATHOS 1 , Periklis I. TOMOS 2, Nikolaos KOSTOMITSOPOULOS 3, Petros G. KOUTSOUKOS 4

1 Department of Cardiac Surgery, Euroclinic of Athens, Athens, Greece; 2 Academic Department of Thoracic Surgery, Attikon University General Hospital, Chaidari, Greece; 3 Center of Experimental Surgery and Translational, Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece; 4 Department of Chemical Engineering, Institute of Chemical Engineering Sciences of FORTH, University of Patras, Patras, Greece

BACKGROUND: Calcification remains the major role of failure of implantable biomedical material and in particular of bioprosthetic valves. Various treatments have been proposed to mitigate calcification of glutaraldehyde-fixed bioprosthetic valves but none have succeeded in inhibiting or mitigating efficiently the calcification process of the implantable biological tissues. Sodium bisulfite is a reducing reagent, which react with free aldehydes. It is postulated, that tissue calcification may be efficiently minimized by forming sulfite and bisulfite adducts with aldehyde groups thus eliminating the places of the biological tissues onto the calcium cations could be deposited.
METHODS: Fresh porcine aortic leaflets were cut radially in three parts. Three groups of tissue were created. Group I (glutaraldehyde only), group II (2.5% Bisulfite) and group III (12.5% Bisulfite). The tissues of group II and group III were fixed first in buffered glutaraldehyde solution 0.5% and then treated with buffered Bisulfite solution of 2.5% and 12.5% respectively at pH of 7.4 for 24 hours. The tissues were then transferred to buffered glutaraldehyde solution 0.5% for 1 week. All tissues were then implanted subdermally in three sets of 8 (group I and group II) and 5 (group III) male Wistar rats of 12 days old. 21 days later the rats were euthanized by inhalation of CO2. The tissues were retrieved and after rinsing with distilled water 3 times, were lyophilized at -40°C at high vacuum pressure of approximately 100 mmHg for 16 hours. The calcium content was then measured with flat atomic absorption technique.
RESULTS: The preimplantation values of Ca concentration as expressed in mg Ca/gr of tissue were 6.26±0.49 in group I, 7.52±0.33 in group II and 5.64±0.45 in group III. 21 days later the values of Ca concentration were 126.95±12.97 for group I, 8.87±0.74 for group II (P<0.01) and 6.49±0.26 for group III (P<0.01). There was not significance difference between groups II and III. Group III showed a slighter less percentage of Ca concentration accumulation than group II (15.07% versus 17.95%, p=ns).
CONCLUSIONS: An anticalcification treatment based on sodium bisulfite and bisulfite adducts, mitigates rather efficiently the calcification process of the implantable biological tissues as compared to glutaralrdehyde treatment only.

KEY WORDS: Sodium bisulfite; Calcification, physiologic; Tissues

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