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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

In vivo endothelialization of cardiac bioprostheses: conventional versus non-aldehyde preservation

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Author(s):
Vinicius José da Silva Nina [1] ; Pablo Maria Alberto Pomerantzeff [2] ; Ivan Sérgio Joviano Casagrande [3] ; David Chung [4] ; Carlos Manuel de Almeida Brandão [5] ; Sérgio Antonio Barbosa do Nascimento [6] ; Luiz Alberto Benvenuti [7] ; Sérgio Almeida de Oliveira [8]
Total Authors: 8
Affiliation:
[1] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
[2] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
[3] International Heart Institute of Montana - Estados Unidos
[4] International Heart Institute of Montana - Estados Unidos
[5] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
[6] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
[7] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
[8] Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas
Total Affiliations: 8
Document type: Journal article
Source: Revista Brasileira de Cirurgia Cardiovascular; v. 19, n. 2, p. 144-151, 2004-06-00.
Abstract

OBJECTIVE: A protective layer of endothelial cells (EC) of host origin on the entire surface of bioprosthetic heart valves has never been reported. Current commercial bioprosthetic heart valves are commonly preserved in glutaraldehyde (GA) and are cytotoxic to host cells preventing spontaneous endothelialization. The aim of this study is to demonstrate the potential for in vivo endothelialization of heart valves treated by the L.-Hydro™ preservation process. METHOD: L-Hydro™ preservation process consists of mild extraction of antigenic substances by the action of polyethyleneglycol and incorporation of an anti-inflammatory and a anti-thrombotic agent. Seven stented porcine valves treated by the L-Hydro™ process and three GA-fixed porcine valves were implanted in the mitral position of juvenile sheep. The valves were evaluated by echocardiography and angiography prior to sacrifice at five months. Recovered valves were also histologically and histo-chemically evaluated. RESULTS: There were no hemodynamic differences between the groups. However, scanning and transmission electron microscopy showed a nearly complete coverage of EC on the surfaces of all leaflets in the L-Hydro™ treated valves. The EC were in direct contact with the underlying collagen layer and expressed von Willebrand-related antigens (vW). The surfaces of the GA-treated valves were covered by fibrin deposition, macrophages, calcium and thrombotic material. Only sparse EC were observed and contact of the EC where the underlying tissue was incomplete. CONCLUSION: These data indicate that L-Hydro™ treated porcine valve tissues are capable of inducing spontaneous endothelialization with evidence of strong cell attachment of the new endothelium to the collagen matrix. (AU)