Fatigue-induced damage in glutaraldehyde-preserved heart valve tissue

Glutaraldehyde-preserved porcine mitral leaflet tissue has been subjected to extended accelerated fatigue loading in Ringer's solution containing 0.15% glutaraldehyde. Five tissue test pieces were subjected to cyclic tensile stresses of 50 and 200 Gm. per square millimeter and to 300 million to 800 million accumulated fatigue cycles. Tissue disruption occurred in each of the fatigued test pieces. Tensile loading, apart from reducing the acuteness of the collagen waveform and thereby decreasing tissue compliance, does not contribute significantly to the disruption process nor its rate of occurrence. Compressive flexure occurring during the unloading half of the fatigue cycle, however, does induce damage in the tissue. Mechanisms involved in the disruptive processes have been identified by conducting simultaneous morphologic and stress/strain observations on both the fatigued and unfatigued tissues in their wet functional condition. This vulnerability of the preserved tissue to compressive flexure could well affect the long-term durability of the glutaraldehyde-preserved heterograft valve, and this possibility is discussed in relation to the clinical use of these valves.