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Published on: August 23, 2011
Bovine aortic and human dura mater valves: a comparative study in artificial hearts in calves
Insights
Human dura mater valves (HDVs) demonstrate superior durability compared to glutaraldehyde-treated bovine aortic valves (BAVs) in artificial hearts. HDVs exhibit less calcification and degradation, suggesting tissue structure is key to long-term performance.
Area of Science:
- Biomaterials Science
- Cardiovascular Surgery
- Tissue Engineering
Background:
- Tissue heart valves are crucial for cardiovascular repair.
- Durability and biocompatibility of implanted valves are critical for patient outcomes.
- Glutaraldehyde treatment enhances tissue valve longevity but may not prevent degradation.
Purpose of the Study:
- To compare the durability and blood compatibility of glutaraldehyde-treated bovine aortic valves (BAVs) and glycerol-treated human dura mater valves (HDVs) in artificial hearts.
- To investigate the impact of hemodynamic environments on tissue valve degradation.
- To identify factors influencing long-term performance of bioprosthetic valves.
Main Methods:
- Implantation of 31 BAVs and 105 HDVs into artificial hearts in calves for up to 316 days.
- Comparative analysis of valve degradation, calcification, and blood compatibility under varying hemodynamic conditions.
- Histopathological examination of valve tissues to assess collagen degradation and pathological changes.
Main Results:
- Both BAVs and HDVs exhibited good blood compatibility.
- Collagen degradation and void formation were observed in both valve types, initiating early in BAVs (7 days) and HDVs (13 days).
- Calcification occurred in 70.9% of BAVs versus 7.6% of HDVs, with all BAVs used >30 days showing calcification.
- Pathological changes were more severe on the left side of artificial hearts.
- HDVs proved significantly more durable than BAVs.
Conclusions:
- Glycerol-treated HDVs are more durable than glutaraldehyde-treated BAVs in artificial heart applications.
- Hemodynamic stress significantly affects tissue valve degradation.
- While glutaraldehyde treatment improves durability, inherent tissue structure plays a vital role in long-term bioprosthetic valve performance.
Abstract:
Thirty-one glutaraldehyde-treated bovine aortic valves (BAVs) and 105 glycerol-treated human dura mater valves (HDVs) were used in 51 various artificial hearts up to 316 days in calves. Multiple valves were implanted in the same animal under different hemodynamic conditions. A comparative study of these valves was performed in terms of blood compatibility and durability with relation to the different hemodynamic environments. Both BAVs and HDVs showed good blood compatibility. The degradation of collagen bundles of the valves began as early as 7 days in BAVs and 13 days in HDVs, and was seen in the hinged portions of the cusps. The fiber separation and resultant void formation were followed with insudation of blood elements and subsequent calcification. Calcification was dystrophic in nature and was encountered in 70.9% of BAVs and 7.6% of HDVs. All 17 BAVs used more than 30 days were calcified; in HDVs the earliest calcified lesion was seen in a 78 day specimen. The pathological changes were more severe in the left side than the right of the total artificial hearts. These results clearly indicated that the HDV is more durable than the glutaraldehyde-treated BAV. It was suggested that degradation of these tissue valves is greatly affected by the degree of hemodynamic stress on the valve cusp. Although glutaraldehyde treatment has increased the durability of tissue valves in general, the structure of the valve tissue also plays an important role in long-term durability.
