Key result
Glutaraldehyde-preserved kangaroo aortic valves showed similar valve leaflet calcification compared to Freestyle stentless valves in juvenile sheep (1.27 vs 2.38 microg Ca/mg tissue; P=0.856).
Why the study?
Does the glutaraldehyde-preserved kangaroo aortic valve reduce calcification compared to the Freestyle stentless bioprosthesis in a juvenile sheep model?
Does the glutaraldehyde-preserved kangaroo aortic valve reduce calcification compared to the Freestyle stentless bioprosthesis in a juvenile sheep model?
Glutaraldehyde-preserved kangaroo aortic valves demonstrate similar low leaflet calcification compared to AOA-treated Freestyle valves in a juvenile sheep model, suggesting potential longevity benefits without antimineralization treatment.
Answers are grounded in this paper and cite their sources.
Similar calcification in sheep model warrants no practice change; leaves open hypothesis of kangaroo valves without antimineralization treatment.
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, variant-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 (microg 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.
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Neethling et al. (2005) studied Valve replacement (n=10). Glutaraldehyde-preserved kangaroo stentless aortic valves vs. Freestyle stentless aortic valves was evaluated on Valve leaflet calcification (microg Ca/mg tissue) (p=0.856). Glutaraldehyde-preserved kangaroo aortic valves showed similar valve leaflet calcification compared to Freestyle stentless valves in juvenile sheep (1.27 vs 2.38 microg Ca/mg tissue; P=0.856).
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