An In Vivo Experimental Study of Bioprosthetic Cardiac Valves in the Tricuspid Position
Shermetaro, Carl B.
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Because bioprosthetic cardiac valves undergo degeneration and calcification, an in vivo investigational model was developed to study these problems. The animal model utilized In this study was the domestic sheep (Ovis aries). The purpose of this study was to compare the untreated porcine and bovine valves with the treated porcine aortIc and bovine pericardial valves by hemodynamic assessments and by studying the morphological degeneration and calcification characteristics of the valves. Eighty juvenile sheep underwent implantation of four groups of bioprosthetic valves In the tricuspid position. Bioprosthetic valves are composed partially of biological tissue, the leaflets, and partially of prosthetic material, the leaflets' supporting structures. Cardiopulmonary bypass was utilized for the Implantation of the valves. In the 80 sheep, the bioprosthetic valves remained Implanted for an average of 21.1 +/- 0.6 weeks. The average age at the time of explantation was 36.8 +/- 2.1 weeks. The average body weight was 44.8 +/- 2.3 kg. The four groups of bioprosthetic valves used consisted of 25 standard (untreated) glutaraldehyde-preserved porcine aortic valves; 25 standard (untreated) glutaraldehyde-preserved bovine pericardial valves; 18 porcine aortic valves treated with a surfactant (sodium dodecyl sulfate) and 12 porcine aortic valves treated with toluidine blue (an organic dye). The treated porcine aortic valves were found to develop less calcification than those which were untreated.