Triglycidyl Amine Crosslinking Combined With Ethanol Inhibits Bioprosthetic Heart Valve Calcification

摘要: Background One of the most important factors responsible for calcific failure bioprosthetic heart valves is glutaraldehyde crosslinking. Ethanol (EtOH) incubation after crosslinking has previously been reported to confer anticalcification efficacy bioprostheses. The present studies investigated in vivo novel agent, triglycidyl amine (TGA), with or without EtOH incubation, comparison glutaraldehyde. Methods TGA (± EtOH) was used prepare porcine aortic both rat subdermal implants and sheep mitral valve replacements, comparisons glutaraldehyde-fixed controls. Thermal denaturation temperature, an index crosslinking, cholesterol extraction, hydrodynamic properties were quantified. Explant endpoints included quantitative morphologic assessment calcification. Results temperatures intermediate between unfixed glutaraldehyde-fixed. resulted almost complete extraction from cusps. Rat explants (90 days) demonstrated that TGA-EtOH a significantly greater level inhibition calcification than other conditions. Thus, TGA-ethanol stent mounted bioprostheses fabricated glutaraldehyde-pretreated In studies, had lower pressure gradients as replacements juvenile (150 calcium levels explanted cusp wall samples compared However, also isolated nodules intracuspal hematomas. Conclusions pretreatment confers significant resistance circulatory implants, but associated structural instability.