In vivo behavior of epoxy-crosslinked porcine heart valve cusps and walls

✍ Scribed by van Wachem, Pauline B. ;Brouwer, Linda A. ;Zeeman, Raymond ;Dijkstra, Piet J. ;Feijen, Jan ;Hendriks, Marc ;Cahalan, Patrick T. ;van Luyn, Marja J. A.

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 610 KB
• Volume: 53
• Category: Article
• ISSN: 0021-9304
• DOI: 10.1002/(sici)1097-4636(2000)53:1<18::aid-jbm3>3.0.co;2-j

✦ Synopsis

Calcification limits the long-term durability of xenograft glutaraldehyde-crosslinked heart valves. In this study, epoxy-crosslinked porcine aortic valve tissue was evaluated after subcutaneous implantation in weanling rats. Non-crosslinked valves and valves crosslinked with glutaraldehyde or carbodiimide functioned as control. Epoxy-crosslinked valves had somewhat lower shrinkage temperatures than the crosslinked controls, and within the series also some macroscopic and microscopic differences were obvious. After 8 weeks implantation, cusps from non-crosslinked valves were not retrieved. The matching walls were more degraded than the epoxy- and control-crosslinked walls. This was observed from the higher cellular ingrowth with fibroblasts, macrophages, and giant cells. Furthermore, non-crosslinked walls showed highest numbers of lymphocytes, which were most obvious in the capsules. Epoxy- and control-crosslinked cusps and walls induced lower reactions. Calcification, measured by von Kossa-staining and by Ca-analysis, was always observed. Crosslinked cusps calcified more than walls. Of all wall samples, the non-crosslinked walls showed the highest calcification. It is concluded that epoxy-crosslinked valve tissue induced a foreign body and calcification reaction similar to the two crosslinked controls. Therefore, epoxy-crosslinking does not represent a solution for the calcification problem of heart valve bioprostheses.