Key result
Bioprosthetic mitral valves constructed with decellularized bovine pericardium fixed in 0.1% glutaraldehyde showed a significant 89% reduction in calcium content compared to controls after 180 days.
Why the study?
The authors sought to characterize 0.1% glutaraldehyde-fixed decellularized bovine pericardium and evaluate bioprosthetic valve outcomes after implantation in the mitral position of juvenile sheep.
Does decellularized bovine pericardium fixed in 0.1% glutaraldehyde reduce calcification compared to standard fresh bovine pericardium fixed in 0.5% glutaraldehyde in juvenile sheep undergoing mitral valve replacement?
Does decellularized bovine pericardium fixed in 0.1% glutaraldehyde reduce calcification compared to standard fresh bovine pericardium fixed in 0.5% glutaraldehyde in juvenile sheep undergoing mitral valve replacement?
Decellularized bovine pericardium fixed in low glutaraldehyde concentration significantly reduces calcification and improves tissue remodeling in a sheep model of mitral valve replacement.
Answers are grounded in this paper and cite their sources.
Reduces calcification in a sheep model; leaves open translation to human bioprosthetic mitral valves.
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.
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Collatusso et al. (2019) studied Bioprosthetic valve calcification (n=16). Decellularized bovine pericardium fixed in 0.1% glutaraldehyde vs. Fresh bovine pericardium fixed in 0.5% glutaraldehyde was evaluated on Calcium content and histological evaluation after 180 days (89% reduction). Bioprosthetic mitral valves constructed with decellularized bovine pericardium fixed in 0.1% glutaraldehyde showed a significant 89% reduction in calcium content compared to controls after 180 days.
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