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High glutaraldehyde concentrations mitigate bioprosthetic root calcification in the sheep model
P Zilla1, C Weissenstein, P Human
1Department of Cardiothoracic Surgery, University of Cape Town Medical School, South Africa. ctszilla@Samiot.uct.ac.za
The Annals of Thoracic Surgery
|January 13, 2001
Summary
Higher glutaraldehyde (GA) concentrations reduce bioprosthetic calcification in sheep. Improved cross-linking outweighs GA accumulation, showing a significant anticalcific effect in aortic wall tissue.
Area of Science:
- Biomaterials science
- Cardiovascular research
- Tissue engineering
Background:
- High glutaraldehyde (GA) concentrations previously showed reduced bioprosthetic calcification in rats.
- Verification in a large animal model was needed to confirm these findings.
Purpose of the Study:
- To evaluate the effect of varying glutaraldehyde (GA) concentrations on bioprosthetic calcification in a sheep model.
- To assess calcification and inflammation at different time points post-implantation.
Main Methods:
- Porcine aortic roots were fixed with 0.2%, 1.0%, or 3.0% GA.
- Implantation into the distal aortic arch of sheep, with assessment at 6 weeks and 6 months.
- Quantitative and qualitative analysis of calcification and inflammation.
Main Results:
- Increasing GA concentration reduced aortic wall calcification by 38% at 6 weeks and 34% at 6 months (p < 0.01).
- Mineralization was associated with elastin, with calcium in cell nuclei and membranes.
- Leaflet calcification was minimal, appearing as nodular deposits at 6 months; inflammatory response was similar across groups.
Conclusions:
- The anticalcific effect of enhanced cross-linking with GA outweighs its intrinsic pro-calcific effect.
- Higher GA concentrations are effective in mitigating bioprosthetic aortic wall calcification in a sheep model.
- The findings support optimized GA fixation for improved bioprosthetic heart valve durability.