STRUCTURAL-CHANGES IN GLUTARALDEHYDE-TREATED PORCINE HETEROGRAFTS USED AS SUBSTITUTE CARDIAC VALVES - TRANSMISSION AND SCANNING ELECTRON-MICROSCOPIC OBSERVATIONS IN 12 PATIENTS
STRUCTURAL-CHANGES IN GLUTARALDEHYDE-TREATED PORCINE HETEROGRAFTS USED AS SUBSTITUTE CARDIAC VALVES - TRANSMISSION AND SCANNING ELECTRON-MICROSCOPIC OBSERVATIONS IN 12 PATIENTS
复制标题
DOI：
10.1016/0002-9149(78)90873-1
复制
发表时间：
1978-01-01
影响因子：
2.8
通讯作者：
ROBERTS, WC
中科院分区：
文献类型：
--
作者：
FERRANS, VJ;SPRAY, TL;ROBERTS, WC
扫描和透射电镜观察(1)12个经戊二醛处理的猪异种瓣膜移植物，植入患者2天至76个月；(2) 3个未植入的商业加工猪主动脉瓣；(3) 1个未加工的猪主动脉瓣。未加工的猪瓣膜与未植入的商业加工瓣膜的比较显示，在植入前加工过程中内皮细胞和酸性粘多糖的损失。植入后短期（不到2个月）的变化包括血浆蛋白绝缘，红细胞渗入表面缝隙，形成薄的纤维蛋白表层，巨噬细胞、巨细胞和少量血小板沉积。较长期（超过2个月）的变化与植入后的时间间隔成正比，包括胶原蛋白的进行性破坏，瓣膜表面的侵蚀，血小板聚集的形成和脂质的积累。小叶的表面没有被内皮或纤维鞘所覆盖。在一个瓣膜中发现钙化沉积物，在另一个瓣膜中发现细菌。因此，胶原蛋白的渐进式分解似乎是决定戊二醛处理的猪异种瓣膜移植的长期耐久性的关键因素。
Scanning and transmission electron microscopic studies were made of (1) 12 glutaraldehyde-treated porcine valvular heterografts that had been implanted in patients for 2 days to 76 months; (2) 3 unimplanted commercially processed porcine aortic valves; and (3) 1 unprocessed porcine aortic valve. Comparison of unprocessed porcine valves and unimplanted commercially processed valves showed loss of endothelium and acid mucopolysaccharides during preimplantation processing. Short-term (less than 2 months) changes after implantation consisted of insudation of plasma proteins, penetration of erythrocytes into surface crevices, formation of a thin surface layer of fibrin, and deposition of macrophages, giant cells and a few platelets. Longer-term (more than 2 months) changes were proportional to the time interval after implantation and consisted of progressive disruption of collagen, erosion of the valve surfaces, formation of aggregates of platelets and accumulation of lipid. The surfaces of the leaflets did not become covered with endothelium or with a fibrous sheath. Calcific deposits were found in one valve and bacterial organisms in another. Thus, progressive breakdown of collagen appears to be a critical factor in determining the long-term durability of glutaraldehydetreated porcine valvular heterografts.