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


Wachem, Pauline B. van and Brouwer, Linda A. and Zeeman, Raymond and Dijkstra, Piet J. and Feijen, Jan and Hendriks, Marc and Cahalan, Patrick T. and Luyn, Marja J.A. van (2000) In vivo behavior of epoxy-crosslinked porcine heart valve cusps and walls. Journal of biomedical materials research, 53 (1). pp. 18-27. ISSN 0021-9304

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Abstract: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.
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Copyright:© 2000 Wiley InterScience
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