Vetter H O, Factor S M, Frater R W
Thorac Cardiovasc Surg. 1987 Feb;35(1):11-5. doi: 10.1055/s-2007-1020189.
In 11 weanling sheep chordae tendineae were replaced or a patch was implanted into the anterior mitral leaflet using homologous pericardium treated with 98% glycerol for 16.6 days on average. The sheep were electively sacrificed after 4, 6, 9, and 12 months. All animals showed competent mitral valves and good healing; only two sheep out of the patch-group showed small perforations at the suture line. Hemodynamic measurements and left ventricular angiography at rest and during stress test were normal except for the two cases. Histological examination revealed a distorsion and breakdown of pericardial collagen already after 4 months but the remnants of the graft were covered by a neointima of fibrous tissue. There were no signs of calcification and the new chordae tendineae and the patches were not shrunk, rigid or thickened. It is concluded that glycerol is a poor tanning agent, however, glycerol-treated pericardium seems to provide a lattice until fibrous tissue replacement has taken place. Therefore, we think it is a suitable material for mitral valve reconstruction.
在11只断奶绵羊中，使用平均用98%甘油处理16.6天的同种心包，替换腱索或在前叶二尖瓣植入补片。绵羊分别在4、6、9和12个月后被选择性处死。所有动物的二尖瓣功能良好且愈合良好；补片组中只有两只绵羊在缝线处出现小穿孔。除这两例病例外，静息和应激试验时的血流动力学测量和左心室血管造影均正常。组织学检查显示，4个月后心包胶原就已扭曲和断裂，但移植物的残余部分被纤维组织的新生内膜覆盖。没有钙化迹象，新的腱索和补片没有收缩、变硬或增厚。结论是甘油是一种较差的鞣剂，然而，经甘油处理的心包似乎能提供一个支架，直到纤维组织替代发生。因此，我们认为它是二尖瓣重建的合适材料。
