Iaroshinskiĭ Iu N, Blagoveshchenskaia R P, Mozhina A A
Arkh Patol. 1981;43(4):40-7.
The investigation was based on the examinations of 85 aortal valves of man and swine after conservation in 1% betapropiolactone solution, 4% formaldehyde solution, 0.6% glutaraldehyde solution and after treatment with gamma-rays preceded by freezing. Besides, 38 allo- and xenotransplants of valves preserved by the above methods which had functioned in the mitral and tricuspidal positions in patients for 1 day to 9 years were examined. Implantation of the grafts was found to complete by 5-6 months. Irrespective of the period of functioning, no encapsulation and cusp formation occurred in the transplanted valves. The time course of destruction of cusp tissue of transplants after various periods of their functioning in the human heart was elucidated. The four main factors causing the development of destructive changes and insufficiency of transplanted valves were detected: biological, mechanical, hemodynamical, and septic. Moderate structural alterations slowly developing in transplanted valves previously preserved in glutaraldehyde and functioning for long periods in the tricuspidal position suggest that valve transplantation (with this method of preservation) in treatment of acquired valvular disease is encouraging.
该研究基于对85个保存于1%β-丙内酯溶液、4%甲醛溶液、0.6%戊二醛溶液中的人及猪主动脉瓣，以及经冷冻后再用γ射线处理的主动脉瓣的检查。此外，还检查了38个用上述方法保存的瓣膜的同种异体和异种移植，这些移植瓣膜在患者的二尖瓣和三尖瓣位置发挥功能1天至9年。发现移植物植入在5至6个月内完成。无论功能发挥的时间长短，移植瓣膜均未出现包囊形成和瓣叶形成。阐明了移植瓣膜在人心脏中不同功能期后瓣叶组织破坏的时间进程。检测到导致移植瓣膜发生破坏性变化和功能不全的四个主要因素：生物学因素、机械因素、血液动力学因素和感染因素。先前保存在戊二醛中并在三尖瓣位置长期发挥功能的移植瓣膜中缓慢发展的中度结构改变表明，（采用这种保存方法的）瓣膜移植在后天性瓣膜疾病治疗中是有前景的。
