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Chirurgia 2021 October;34(5):204-8

DOI: 10.23736/S0394-9508.20.05192-X


language: English

A comparison between sodium bisulfite and Therma-Fix® anticalcification treatments for implantable biological tissues

Efstathios A. AGATHOS 1 , Elias LACHANAS 2, Spyridon AGATHOS 1, Periklis I. TOMOS 3, Nikolaos KOSTOMITSOPOULOS 4, Petros G. KOUTSOUKOS 5

1 Department of Cardiac Surgery, Euroclinic of Athens, Athens, Greece; 2 Department of Cardiac Surgery, Agias Sofias Children’s Hospital, Athens, Greece; 3 Department of Thoracic Surgery, Attikon University General Hospital, Athens, Greece; 4 Center of Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece; 5 Department of Chemical Engineering and FORTH-ICEHT, University of Patras, Patras, Greece

BACKGROUND: Various treatments have been proposed to eliminate the progressive dystrophic calcification of Glutaraldehyde (Glut) fixed bioprosthetic valves. Sodium Bisulphite (BSF) treatment has been introduced as an independent anticalcification strategy. Its efficacy is tested versus an established anticalcification treatment such as Therma-Fix®, using long term rat subdermal implantation to compare the accumulation of calcium in the implanted tissues.
METHODS: Three groups were created from porcine aortic leaflets: Group I (Glut 0.5% with 12.5% BSF), Group II (Glut 0.625% with Therma -Fix®) and Group III (Glut 0.5% only). All tissues were implanted subdermally in three sets of 8 (Group I), 7 (Group II) and 8 (Group III) Wistar rats. 16 weeks later the tissues were retrieved and lyophilized at -40°C at a vacuum pressure of 100mmHg.The calcium content was measured with flat atomic absorption technique.
RESULTS: The preimplantation Ca concentration in mg Ca/g of tissue was 14.32± 3.15 in Group I, 1.38 ±0.08 in Group II and 1.79±0.14 in Group III (P=ns). 16 weeks later the Ca concentration was 113.73 ±7.27 (P<0.05), 2.58±0.87 (P<0.05) and 277.55±32.52 respectively. There was also a significance difference (P<0.05) between Groups II and I.
CONCLUSIONS: Even if Sodium Bisulphite mitigates the calcification significantly as compared to Glutaralrdehyde treatment only, Therma-Fix® treatment offers superior long term anticalcification effect.

KEY WORDS: Heart valve prosthesis implantation; Calcinosis; Therapeutics

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