Scanning and transmission electron microscopic study of recovered porcine aortic valved conduits

Four explanted porcine aortic valved conduits were examined using scanning and transmission electron microscopy. Sources of obstruction such as neointima or "peel" and calcification were observed. In one sample the neointima was found to possess an unusually large expanse of squamous cells partially lining the luminal surface. This lining much resembled a normal endothelium, which is not an expected feature of neointima. Cells, presumably of host origin, were noted upon the leaflet surfaces. They did not seem as well organized as those found on the neointima. Calcification did not seem greatly advanced but was clearly apparent. Certain treatments proposed by others to curtail calcification are discussed and amended herein. SEM examination of three of these conduits provided good evidence of lining cells on only the inflow surface of the leaflet. The fourth conduit, however, showed cells on both inflow and outflow surfaces. These cells possessed certain characteristics of cells from leaflets of the other three conduits, but questions remain as to the precise identification of all of these lining cells. TEM examination provided cytological evidence of macrophage-like cells lining the inflow surface of a leaflet.