Carpentier S M, Chen L, Shen M, Fornes P, Martinet B, Quintero L J, Witzel T H, Carpentier A F
Laboratoire d'Etude des Greffes et Prothèses Cardiaques, Université Paris VI, Hôpital Broussais, France.
Ann Thorac Surg. 1998 Dec;66(6 Suppl):S264-6. doi: 10.1016/s0003-4975(98)01101-1.
Several techniques have been proposed to mitigate calcification of glutaraldehyde-preserved bioprostheses. None has been fully satisfactory. Knowing that heat induces significant molecular changes, we investigated the potential benefit of the heat treatment of glutaraldehyde-fixed tissues.
Samples of porcine valves and bovine pericardium treated in 0.625% glutaraldehyde were submitted to temperatures from 37 degrees to 70 degrees C for 2 to 12 weeks and then implanted subcutaneously in newborn rats for 3 months. In a second protocol, nine heat-treated porcine valve bioprostheses and seven control porcine valve bioprostheses were implanted in the mitral position in sheep for 20 weeks.
Spectrophotometry and x-ray analysis comparing heat-treated versus non-heat-treated tissues showed the following: porcine valve: 6.7+/-2.3 microg Ca/mg (n = 8) versus 239.9+/-2.9 /g Ca/mg (n = 8); bovine pericardium: 19.5+/-8 microg Ca/mg (n = 6) versus 108+/-10.3 microg Ca/mg (n = 8); and porcine valve bioprostheses: 0 versus ++.
Heat treatment of glutaraldehyde-treated bioprostheses significantly mitigated calcification in both subcutaneous and mitral position.
已经提出了几种技术来减轻戊二醛保存的生物假体的钙化。但没有一种技术能完全令人满意。鉴于热会引起显著的分子变化，我们研究了对戊二醛固定组织进行热处理的潜在益处。
将在0.625%戊二醛中处理过的猪瓣膜和牛心包样本在37摄氏度至70摄氏度的温度下放置2至12周，然后皮下植入新生大鼠体内3个月。在第二个方案中，将九个经过热处理的猪瓣膜生物假体和七个对照猪瓣膜生物假体植入绵羊的二尖瓣位置20周。
对热处理组织与未热处理组织进行分光光度法和X射线分析，结果如下：猪瓣膜：6.7±2.3微克钙/毫克（n = 8）对239.9±2.9微克钙/毫克（n = 8）；牛心包：19.5±8微克钙/毫克（n = 6）对108±10.3微克钙/毫克（n = 8）；猪瓣膜生物假体：0对++。
对戊二醛处理过的生物假体进行热处理可显著减轻皮下和二尖瓣位置的钙化。
