New aspects of the degeneration of bioprosthetic heart valves after long-term implantation.
作者： Martin Grabenwöger , Michael Grimm , Elisabeth Eybl , Margit Kadletz , Michael Havel
DOI: 10.1016/S0022-5223(19)34831-7
关键词:
摘要: Bioprosthetic heart valves removed 76 to 150 months after implantation were morphologically investigated correlate structural alterations with clinical failure modes. Traditional morphologic methods of evaluating valvular heterografts, such as microradiography and electron microscopy, complemented by undecalcified ground sections, a new technique for analyzing the distribution mineral deposits. Apart from well-investigated mechanisms that accelerate tissue degeneration, our observations point additional facts: (1) phagocytosis collagen fibrils elastic material macrophages foreign body giant cells in areas near tears perforations (2) initial calcification indicated delicate crystals intercellular space arranged close relation periodicity cross-striation pattern fibrils. The present report not only calls attention degenerative changes are enhanced mechanical stress but also underlines an important mechanism destruction bioprosthetic valves. (J T horac C ardiovasc S urg 1992;104:14–21)
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