Prevention of calcification with TPEN in pericardial bioprosthetic heart valve material

Abstract

Objective: Calcification is a frequent cause of the clinical failure of bioprosthetic heart valves fabricated from glutaraldehyde pretreated bovine pericardium. The major object of the present study is to prevent calcification of pericardial bioprosthetic heart valve materials with TPEN.

Methods: Bovine pericardium was cut into 2-cm 2 pieces, rinsed in phosphate-buffered saline solution, transferred into +4 degrees C phosphate-buffered saline containing 0.625% glutaraldehyde for initial fixation for 48 h, and allocated into two groups. Control samples were treated in an identical fresh solution for five more days. Others underwent additional fixation in phosphate-buffered saline 2microM TPEN for 48 h. They were then transferred into phosphate-buffered saline + 0.625% glutaraldehyde solution at 37 degrees C (pH 7.4) for three more days. Pericardial patches were inserted into the dorsal pouches of 18 juvenile male Wistar rats as control and study groups. Rats were divided into two groups and sacrificed consecutively by the end of 9th and 12th weeks. The biomechanical properties and calcium contents of explanted tissues were tested and were also assessed histopathologically.

Results: The difference in the calcium contents of the control and study groups' pericardial tissues at the 9th, and 12th weeks were statistically significant (p=0.0001, p=0.0001). The comparison of calcium contents between controls of 9th and 12th weeks and study groups' of the 9th and 12th weeks pericardial tissues were also significant (p=0.0001 and p=0.0001). Histopathologic and biomechanical assessment also supported these findings.

Conclusion: Calcific degeneration of glutaraldehyde-fixed bovine pericardium can be reduced by using TPEN without any effect on durability.