Rapid anticalcification treatment for glutaraldehyde-fixed autologous tissue in cardiovascular surgery
Shotaro Kaneko1, Susumu Isoda2, Toru Aoyama2
1Department of Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. kaneko.shotaro.903@gmail.com.
Insights
A rapid ethanol treatment effectively prevents calcification in glutaraldehyde-fixed tissues. This method offers a potential solution for intraoperative anticalcification of autologous tissues in cardiovascular surgery.
Area of Science:
- Biomaterials Science
- Tissue Engineering
- Cardiovascular Surgery
Background:
- Glutaraldehyde (GA)-fixed autologous tissues are crucial for cardiovascular surgery but prone to calcification.
- Current methods lack rapid intraoperative anticalcification solutions.
- Ethanol treatment shows promise for preventing bioprosthetic valve calcification.
Purpose of the Study:
- To establish a rapid anticalcification method for GA-fixed autologous tissues using ethanol.
- To evaluate the efficacy of varying ethanol treatment durations on preventing tissue calcification.
Main Methods:
- Thoracic aorta tissues were fixed with GA and treated with ethanol for 0, 10, 20, or 30 minutes.
- Treated tissues were implanted subdermally in rats for 28 days.
- Calcification was evaluated semiquantitatively using virtual slide analysis.
Main Results:
- Ethanol treatment significantly reduced calcification in GA-fixed tissues compared to untreated controls and 0-minute treatment.
- 20 and 30-minute ethanol treatments showed significant anticalcification effects.
- A 10-minute ethanol treatment demonstrated a trend towards decreased calcification.
Conclusions:
- Rapid ethanol treatment effectively prevents calcification of GA-fixed tissues in a rat model.
- This method holds potential for intraoperative anticalcification of autologous tissues in cardiovascular procedures.
Background:
Glutaraldehyde (GA)-fixed autologous tissues, including the pericardium, are widely used as patches and valve substitutes in cardiovascular surgery. However, GA treatment causes tissue calcification. No rapid anticalcification method has been established for use during surgery. Here, we aimed to establish a rapid anticalcification method using ethanol, as has already been demonstrated for bioprosthetic valves.
Methods:
Thoracic aorta tissues were first fixed with GA for 3 min and then treated with ethanol for 0 (group 2), 10 (group 3), 20 (group 4), and 30 (group 5) min; untreated tissues (group 1) served as the control. The treated tissues were subdermally implanted into 3-week-old male Wistar rats and kept in place for 28 days. The calcification in each explant was semiquantitatively evaluated by annotating and measuring the area using virtual slides, and the data obtained were statistically analyzed.
Results:
Semiquantitative analysis revealed that calcification of the implants from the untreated group (group 1; P = 0.0014) and groups 4 (P = 0.0014) and 5 (P = 0.0031) was significantly lower than that of implants from group 2. Moreover, implants from group 3 showed a tendency toward decreased calcification, although it was not significant (P = 0.0503).
Conclusions:
A rapid ethanol treatment prevents calcification of GA-fixed tissues in a rat model of subdermal implantation. This method may facilitate effective and rapid anticalcification of autologous tissues for use during cardiovascular surgery.
