Decellularization as a method to reduce calcification in bovine pericardium bioprosthetic valves
| Autor: | Francisco Diniz Affonso da Costa, João Gabriel Roderjan, Claudinei Collatusso, Paula Hansen Suss, Lucia de Noronha, Allyson Klosowski, Luiz Cesar Guarita-Souza |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pathology medicine.medical_specialty Bovine pericardium medicine.medical_treatment chemistry.chemical_element 02 engineering and technology 030204 cardiovascular system & hematology Calcium Extracellular matrix 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Medicine Alternative methods Decellularization business.industry Mitral valve replacement 021001 nanoscience & nanotechnology medicine.disease chemistry Surgery Glutaraldehyde 0210 nano-technology Cardiology and Cardiovascular Medicine business Calcification |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 29:302-311 |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES Decellularization is an alternative method for processing biological tissues with decreased antigenicity and resistance to calcification. The aim of this study was to characterize the properties of decellularized (dCell) bovine pericardium fixed with 0.1% glutaraldehyde (GA) and to evaluate outcomes of bioprosthetic valves constructed with this tissue when implanted in the mitral position of juvenile sheep. METHODS Bioprosthetic mitral valves were constructed with fresh bovine pericardium fixed in 0.5% GA (control group) or dCell bovine pericardium fixed in 0.1% GA (study group). Before implantation, samples were submitted to histological (haematoxylin–eosin, Movat and 4′,6-diamidino-2-phenylindole), biochemical (residual deoxyribonucleic acid and α-gal epitopes) and biomechanical characterization. Valves were implanted (n = 8 in each group) as a mitral valve replacement for 180 days in sheep and explants were re-evaluated histologically and for calcification with radiological studies and calcium content determination. RESULTS Unimplanted dCell pericardia exhibited a well-preserved extracellular matrix with absence of cells, a 77% reduction in deoxyribonucleic acid levels and with no detectable α-gal epitopes. When compared to controls, they had lower ultimate tensile strength (7.3 ± 5.4 vs 10.2 ± 3.0 mPa, P = 0.04) and greater percentage elongation in the longitudinal direction (29 ± 6.5% vs 23.8 ± 5.1%, P = 0.02). After 180 days in mitral position, dCell valves showed pliable leaflets without macroscopic signs of calcification. Histologically, dCell leaflets had intact collagen fibres, better tissue remodelling and a significant 89% reduction in calcium content. CONCLUSIONS This study demonstrates that bioprosthetic valves constructed with dCell bovine pericardium fixed in low GA concentration were resistant to calcification and may thereby improve long-term durability of the tissue. |
| Databáze: | OpenAIRE |
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