Abstract 12201: Recellularization Potential of Glutaraldehyde-Free Aortic Valves
Objective: Decellularized porcine heart valves treated with deoxycholic acid (DOA) have showed complete recellularization and absence of calcification when implanted into the pulmonary position in sheep. We studied recellularization and calcification in stented DOA-treated heart valves and compared them with conventional stented glutaraldehyde-treated (GA) valves in the aortic position in juvenile pigs.
Methods: DOA heart valves (n=12) and Carpentier-Edwards GA valves (n=15) were implanted into the aortic position in 8-month old 90kg female pigs. Six months postoperatively, the valves were explanted and subjected to high resolution (HR) X-ray imaging and histological evaluation.
Results: Five DOA valves and five GA valves were explanted after 6 months. Fifteen animals died early because of non-valve related causes and two because of infective endocarditis. HR X-ray imaging demonstrated complete absence of cusp calcification in the DOA valves (figure 1A), but mild to severe calcification in all GA valves (Figure 1B). Overgrowth of von Willebrand factor positive endothelial cells and ingrowth of fibroblasts in the stent-adjacent area and basal part of the cusps were seen in all DOA valves (Figure 2A&B), but not in GA valves. Inflammatory cells were observed in larger amounts in all GA valves compared with DOA valves. Intrinsic cusp calcification was present in four GA valves.
Conclusion: DOA-treated heart valves demonstrate greater recellularization and less calcification compared with standard GA-treated valves 6 months after implantation in the aortic position in pigs.
- © 2010 by American Heart Association, Inc.