Cunanan C M, Cabiling C M, Dinh T T, Shen S H, Tran-Hata P, Rutledge J H, Fishbein M C
Heart Valve Therapy Research, Edwards Lifesciences, Irvine, California 92614, USA.
Ann Thorac Surg. 2001 May;71(5 Suppl):S417-21. doi: 10.1016/s0003-4975(01)02493-6.
Tissue properties may contribute to intrinsic calcification of bioprosthetic heart valves. Phospholipids have been proposed as potential nucleation sites for calcification. Other tissue properties might also be important in calcification.
Commercial and control bioprosthetic valve tissues were characterized by shrinkage temperature, moisture content, free amine content, phospholipid content, and calcification level after 90-day rat subcutaneous implantation as described.
Shrinkage temperature, moisture content, and free amine content were typical for glutaraldehyde-cross-linked tissues. Phospholipid and calcium levels varied considerably among valve types. There was a significant correlation between phospholipid levels and calcification (r = 0.63, p = 0.04). Sulzer Carbomedics Mitroflow and Toronto SPV valve tissues had significantly more calcification than other commercial bioprostheses in this study (p < 0.01). Carpentier-Edwards Duraflex, CE SAV, and CE PERIMOUNT valve tissues had significantly less calcification than Medtronic Mosaic in this animal model (p < 0.02).
Processes that reduce phospholipid levels are associated with reduced calcification in the rat subcutaneous model. Significant differences in calcification level were found among commercially available valves. The clinical significance of these results is unknown.
组织特性可能导致生物人工心脏瓣膜的内在钙化。磷脂已被认为是钙化的潜在成核位点。其他组织特性在钙化过程中可能也很重要。
按照所述方法，对商业用和对照生物人工瓣膜组织进行收缩温度、水分含量、游离胺含量、磷脂含量以及大鼠皮下植入90天后钙化水平的测定。
收缩温度、水分含量和游离胺含量是戊二醛交联组织的典型特征。不同瓣膜类型的磷脂和钙水平差异很大。磷脂水平与钙化之间存在显著相关性（r = 0.63，p = 0.04）。在本研究中，苏尔寿卡迈德ics Mitroflow和多伦多SPV瓣膜组织的钙化明显多于其他商业生物人工瓣膜（p < 0.01）。在该动物模型中，卡朋蒂埃 - 爱德华兹Duraflex、CE SAV和CE PERIMOUNT瓣膜组织的钙化明显少于美敦力Mosaic（p < 0.02）。
在大鼠皮下模型中，降低磷脂水平的过程与钙化减少相关。市售瓣膜的钙化水平存在显著差异。这些结果的临床意义尚不清楚。
