Glycosaminoglycan Stabilization Reduces Tissue Buckling in Bioprosthetic Heart Valves

摘要: Currently, bioprosthetic heart valves are crosslinked with glutaraldehyde to prevent tissue degradation and reduce antigenicity. Glutaraldehyde forms stable crosslinks collagen via a Schiff base reaction of the aldehyde an amine group hydroxylysine/lysine in collagen. However, within decade implantation, 2030% these bioprostheses will become dysfunctional over 50% fail due degeneration 12-15 years post-operatively [1, 2]. Gylcosaminoglycans, major constituent valvular tissue, play important role maintaining hydrated environment necessary for absorbing compressive loads, modulating shear stresses, resisting buckling. One disadvantages crosslinking is its incomplete stabilization GAGs [3, 4], which lack functionalities fixation by addition. Previous studies have reported greater depth buckling aortic valves, one causes failure [5, 6]. Buckling occurs at sites sharp bending, producing large stresses that can eventually lead mechanical fatigue consequent degeneration. Local structural collapse areas minimize subsequently reduction length. loss porcine cusps during fixation, storage, vitro experimentation, vivo subdermal implantation enzyme-mediated GAG 4, 7, 8].