Some factors affecting the long-term performance of glutaraldehyde-crosslinked heteroprostheses

Crosslinked proteins undergo degradation in the physiological environment. Recent cumulative evidence with glutaraldehyde-crosslinked xenograft heart valves emphasizes the fact that caution is in order, despite the generally good performance of these valves in comparison to early formaldehyde-crosslinked prostheses. Glutaraldehyde involves complex chemistry yielding heterogeneous crosslinks with respect to the nature and number of crosslinks with proteins and mucopolysaccharides, all of which contribute significantly to physical and biological performance.