Love C S, Love J W
Autogenics, Newbury Park, Santa Barbara, California.
J Card Surg. 1991 Dec;6(4):499-507. doi: 10.1111/j.1540-8191.1991.tb00351.x.
Residual antigenicity of xenograft tissue after glutaraldehyde tanning may be a factor that determines calcification and durability of bioprostheses. We have pursued the concept of a nonantigenic, noncalcifying, more durable bioprosthesis. We previously described a technique for rapid intraoperative fabrication of an autogenous tissue heart valve (ATHV). That technique has been modified to improve reliability and ease of learning. With the modified technique, a geometrically perfect trileaflet valve can be made in 5 minutes. Although any suitable tissue can be used, the pericardial ATHV is the subject of this report. Autogenous pericardium immersed for 5 minutes in glutaraldehyde has proven satisfactory for valve construction. In vitro testing in the pulse duplicator and accelerated life tester has shown that the stent assembly is capable of function beyond 800,000,000 cycles without failure. In vivo testing has been performed in the juvenile sheep model as described by the National Institutes of Health group. Five sheep were maintained for 5 months postimplant before sacrifice. Explanted valves showed no tissue thickening or shrinkage, problems seen with earlier valves made with untreated autogenous tissue, and the leaflets remained pliable, free of the degenerative changes usually seen in the sheep model.
戊二醛鞣制后异种移植组织的残余抗原性可能是决定生物假体钙化和耐久性的一个因素。我们一直在探索一种无抗原性、无钙化且更耐用的生物假体的概念。我们之前描述了一种用于快速术中制作自体组织心脏瓣膜（ATHV）的技术。该技术已被改进以提高可靠性和学习的便利性。采用改进后的技术，可在5分钟内制作出几何形状完美的三叶瓣膜。尽管任何合适的组织都可使用，但心包ATHV是本报告的主题。已证明将自体心包在戊二醛中浸泡5分钟对于瓣膜构建是令人满意的。在脉动复制器和加速寿命测试仪中进行的体外测试表明，支架组件能够在超过8亿次循环的情况下正常运行而无故障。按照美国国立卫生研究院小组的描述，已在幼年绵羊模型中进行了体内测试。5只绵羊在植入后维持5个月然后处死。取出的瓣膜未显示组织增厚或收缩，这是早期用未处理的自体组织制作的瓣膜所出现的问题，并且瓣膜小叶保持柔韧，没有在绵羊模型中通常所见的退行性变化。
