title: [Effect of pre-existing lipids on calcinosis of swine heart valve bioprostheses. A study of a dynamic in vitro model].
abstract: Calcification is one of the main causes of failure of porcine bioprosthetic heart valves, a problem which has not been satisfactorily solved to date. Previous studies have shown that calcification is decreased in porcine heart valves that have undergone treatment for lipid extraction. The relation between lipid distribution and calcification of seven new commercially available porcine bioprosthetic heart valves (St. Jude Medical, Bioimplant) is assessed by Sudan red III staining to show preexisting lipids. All porcine bioprosthetic valves contained lipids to different degrees. Five valves were subjected to the pulsatile accelerated calcification process for 4 weeks. Distribution and level of calcification were evaluated by radiography and compared to the Sudan red-stained fatty areas. Comparison of the calcifications detected by radiography and the macroscopically detected lipids showed a coincidence of 57-66%. Two porcine bioprosthetic valves were histologically prepared and stained with Hematoxylin and von Kossa's stain, respectively. By light microscopy, the von Kossa staining revealed microcalcifications and polarizing microscopic investigation showed birefractive substances in areas with lipid deposits. These preexisting substances in porcine valve tissue may play a determinative role in the calcification of the tissue. Substantial studies are necessary to further determine the role of preexisting lipids in calcification.
authors.affiliation: Gerhard-Domagk-Institut für Pathologie der Universität Münster.
authors.forename: H A
authors.initials: HA
authors.lastname: Baba
authors.forename: M
authors.initials: M
authors.lastname: Deiwick
authors.forename: D
authors.initials: D
authors.lastname: Breukelmann
authors.forename: B
authors.initials: B
authors.lastname: Glasmacher
authors.forename: H H
authors.initials: HH
authors.lastname: Scheld
authors.forename: W
authors.initials: W
authors.lastname: Böcker
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D002114:Calcinosis / Q000473:pathology*; D019544:Equipment Failure Analysis; D006350:Heart Valve Prosthesis; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008955:Models, Cardiovascular; D011183:Postoperative Complications / Q000473:pathology*; D011474:Prosthesis Design; D012307:Risk Factors; D013552:Swine
chemical_list: D008055:Lipids