In vivo evaluation of Vivere bovine pericardium valvular bioprosthesis with a new anti‐calcifying treatment

The objective of this study was to evaluate the effect of chemical treatment with glutamic acid to avoid calcification of biological cardiac valves. The bovine pericardium (BP) tissues were fixed with 0.5% glutaraldehyde (BP/GA), followed by treatment with glutamic acid (BP/GA + Glu) for neutralizat...

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Published in:Artificial organs 2020-11, Vol.44 (11), p.E482-E493
Main Authors: Braile‐Sternieri, Maria C. V. B., Goissis, Gilberto, Giglioti, Aparecida de F., Ramirez, Vladimir D. A., Pereira, Nathalia P., Vasconcellos, Adriano, Basso‐Frazzato, Glaucia G., Braile, Domingo Marcolino
Format: Article
Language:English
Subjects:
Aldehydes
anticalcificant treatment
bovine pericardium
Calcification
Calcification (ectopic)
Calcium
Calcium ions
Chemical treatment
Collagen
crosslinking
Elastin
Fibrils
Glutamic acid
Glutaraldehyde
Heart valves
Industrial applications
Inflammation
Mechanical properties
Microscopic analysis
Neutralization
Pericardium
Sheep
Surgical implants
Thermodynamic properties
Tissues
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Summary:The objective of this study was to evaluate the effect of chemical treatment with glutamic acid to avoid calcification of biological cardiac valves. The bovine pericardium (BP) tissues were fixed with 0.5% glutaraldehyde (BP/GA), followed by treatment with glutamic acid (BP/GA + Glu) for neutralization of the free aldehyde groups. Microscopic analysis showed that the wavy structure of collagen fibrils was preserved, but changes in elastin's integrity occurred. However, the treatment did not promote undesirable changes in the thermal and mechanical properties of the modified BPs. These samples were systematically studied in rat subcutaneous tissue: control (BP/GA) and anticalcificant (BP/GA + Glu). After 60 days, both groups induced similar inflammatory reactions. In terms of calcification, BP/GA + Glu remained more stable with a lower index (3.1 ± 0.2 μg Ca2+/mg dry tissue), whereas for BP/GA it was 5.7 ± 1.3 μg Ca2+/mg dry tissue. Bioprostheses made from BP/GA + Glu were implanted in the pulmonary position in sheep, and in vivo echocardiographic analyses revealed maintenance of valvar function after 180 days, with low gradients and minimal valve insufficiency. The explanted tissues of the BP/GA + Glu group had a lower average calcium content 3.8 ± 3.0 μg Ca2+/mg dry tissue. The results indicated high anticalcification efficiency of BP/GA + Glu in both subcutaneous implant in rats and in the experimental sheep model, which is an advantage that should encourage the industrial application of these materials for the manufacture of bioprostheses.
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.13718