Ferrans V J, Spray T L, Billingham M E, Roberts W C
Pathology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, 20014, USA.
Circulation. 1978 Sep;58(3 Pt 2):I10-8.
Scanning and transmission electron microscopic studies were made of: 1) 15 glutaraldehyde-treated porcine valvular heterografts that had been implanted in patients for periods of time ranging from 2 days to 76 months; 2) unimplanted, commercially processed porcine aortic valves; and 3) unprocessed porcine aortic valves. Unimplanted, commercially processed valves showed loss of endothelium and acid mucopolysaccharides. Short-term (< 2 months) post-implantation changes consisted of insudation of plasma proteins, penetration of erythrocytes into surface crevices, formation of a thin surface layer of fibrin, and deposition of macrophages, giant cells and a few platelets. Longer term (> 2 months) changes consisted of progressive disruption of collagen, erosion of valvular surfaces, formation of aggregates of platelets, and accumulation of lipid. The surfaces of the leaflets did not become covered with endothelium or with a fibrous sheath. It is concluded that progressive breakdown of collagen is a critical factor in determining the long-term durability of glutaraldehyde-treated porcine valvular heterografts.
1）15个经戊二醛处理的猪瓣膜异种移植物，这些移植物已在患者体内植入2天至76个月不等；2）未植入的、经商业处理的猪主动脉瓣膜；3）未处理的猪主动脉瓣膜。未植入的、经商业处理的瓣膜显示内皮和酸性粘多糖缺失。植入后短期（<2个月）的变化包括血浆蛋白渗入、红细胞侵入表面缝隙、形成一层薄的纤维蛋白表面层以及巨噬细胞、巨细胞和少量血小板的沉积。长期（>2个月）变化包括胶原蛋白逐渐破坏、瓣膜表面侵蚀、血小板聚集形成以及脂质积聚。瓣叶表面未被内皮或纤维鞘覆盖。得出的结论是，胶原蛋白的逐渐分解是决定经戊二醛处理的猪瓣膜异种移植物长期耐久性的关键因素。
