Kangaroo versus freestyle stentless bioprostheses in a juvenile sheep model: Hemodynamic performance and calcification behavior
Kangaroo versus freestyle stentless bioprostheses in a juvenile sheep model: Hemodynamic performance and calcification behavior
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DOI：
10.1111/j.0886-0440.2005.05010.x
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发表时间：
2005-01-01
影响因子：
1.6
通讯作者：
Glancy, R
中科院分区：
文献类型：
--
作者：
Neethling, WML;Hodge, AJ;Glancy, R
背景：戊二醛保存的生物人工心脏瓣膜替代品由于组织变性和钙化，其性能和寿命有限。Freestyle瓣膜（美敦力心脏瓣膜公司，明尼阿波利斯，MN）结合了零固定压力和比例氨基酸油酸（AOA）作为抗变性和抗矿化措施。本研究的目的是比较戊二醛保存的袋鼠主动脉瓣与自由式无支架生物假体在幼年羊模型中的钙化行为。方法：采用自由式无支架主动脉瓣（n = 4）或戊二醛保存的袋鼠无支架主动脉瓣（n = 6）对幼年羊进行肺动脉和瓣膜置换术，术后200天切除。结果：自由式无支架主动脉瓣和袋鼠式无支架主动脉瓣术后立即和120天内瓣膜功能正常。所有瓣膜小叶宏观上无明显钙化，组织学正常。袋鼠的瓣叶钙化（杯状Ca/mg组织）少于自由式（1.27 +/- 0.43比2.38 +/- 1.37,p = 0.856）。袋鼠和自由式动物主动脉壁组织钙化严重（127.93 +/- 12.22 vs 122.19 +/- 11.99, p = 0.596）。结论：我们得出结论，在幼年羊的钙化方面，戊二醛保存的袋鼠主动脉瓣小叶与aoa处理的自由式无支架瓣膜小叶是相同的。两种生物假体都容易发生主动脉壁钙化。未经抗矿化治疗的袋鼠主动脉瓣小叶的低钙化特征可能有利于瓣膜的使用寿命。
Background: Glutaraldehyde-preserved bioprosthetic heart valve substitutes have limited performance and longevity due to tissue degeneration and calcification. The Freestyle valve (Medtronic Heart Valves, Inc, Minneapolis, MN) combines zero fixation pressure and proportional to-amino oleic acid (AOA) as antidegeneration and antimineralization measures. The aim of this study was to compare the calcification behavior of glutaraldehyde-preserved kangaroo aortic valves with Freestyle stentless bioprostheses in a juvenile sheep model. Methods: Pulmonary artery and valve replacements were performed in juvenile sheep with Freestyle stentless aortic valves (n = 4) or glutaraldehyde-preserved kangaroo stentless aortic valves with no antimineralization measures (n = 6), and explanted at 200 postoperative days. Results: Freestyle stentless valves and stentless kangaroo aortic valves showed normal valve function immediately postoperatively and up to 120 days. Valve leaflets of all valves were macroscopically free of visible calcification with normal histology. Valve leaflet calcification (mug Ca/mg tissue) was less in kangaroo than Freestyle (1.27 +/- 0.43 versus 2.38 +/- 1.37, p = 0.856). Aortic wall tissue calcification was severe in kangaroo and Freestyle (127.93 +/- 12.22 versus 122.19 +/- 11.99, p = 0.596). Conclusions: We conclude that glutaraldehyde-preserved kangaroo aortic valve leaflets are equal to AOA-treated Freestyle stentless valve leaflets with regard to calcification in juvenile sheep. Both bioprostheses are prone to aortic wall calcification. The low calcification features of the kangaroo aortic valve leaflets without antimineralization treatment may benefit the longevity of the valve.