Effectiveness of different anticalcification treatments for stentless aortic bioprostheses.
BACKGROUND
New anticalcification treatments for stentless bioprostheses have not yet been compared independently.


METHODS
The No-reacts (Biocor), AOA (Medtronic Freestyle), and BiLinx (SJM Toronto SPV II) methods were studied and compared with a control group. Aortic valve leaflet and aortic root tissue was subcutaneously implanted in 60 male, 21-days-old Sprague-Dawley rats. Calcium content was quantified using inductively coupled plasma spectrophotometry.


RESULTS
No infections occurred. Low levels of calcium were measured in aortic valve leaflet tissue for all methods (0.4 to 1.5 mg/g dry weight) in comparison to the control group (225 mg/g), p < 0.01. Calcification of aortic root tissue was low in the Bilinx group (2.4 mg/g, p < 0.01), whereas calcium levels were high in all other groups (104 to 127 mg/g).


CONCLUSIONS
Calcification of aortic valve leaflets was significantly reduced by all new anticalcification treatments, whereas aortic root calcification was only reduced by inhibition of cellular calcification (BiLinx). Maximum anticalcification properties of both leaflet and aortic root are important, as these are considered a functional unit in stentless bioprostheses.
Walther
T
T
Department of Cardiac Surgery, University of Leipzig, Heart Center, Germany. walt@server3.medizin.uni-leipzig.de
Falk
V
V
Diegeler
A
A
Rauch
T
T
Weigl
C
C
Gummert
J
J
Autschbach
R
R
Mohr
F W
FW
D000077410:Aluminum Chloride; D017607:Aluminum Compounds / Q000494:pharmacology; D000818:Animals; D001013:Aorta, Thoracic / Q000378:metabolism; D001018:Aortic Diseases / Q000378:metabolism / Q000517:prevention & control; D001021:Aortic Valve; D001252:Astringents / Q000494:pharmacology; D001705:Bioprosthesis; D002114:Calcinosis / Q000378:metabolism / Q000517:prevention & control*; D002118:Calcium / Q000378:metabolism; D002712:Chlorides / Q000494:pharmacology; D020099:Coated Materials, Biocompatible; D004195:Disease Models, Animal; D004338:Drug Combinations; D000431:Ethanol / Q000494:pharmacology; D005404:Fixatives / Q000494:pharmacology; D005500:Follow-Up Studies; D005976:Glutaral / Q000494:pharmacology; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D008297:Male; D009829:Oleic Acids / Q000494:pharmacology; D011474:Prosthesis Design; D051381:Rats; D017207:Rats, Sprague-Dawley; D012997:Solvents / Q000494:pharmacology; D013193:Stainless Steel; D013501:Surface-Active Agents / Q000494:pharmacology
D017607:Aluminum Compounds; D001252:Astringents; D002712:Chlorides; D020099:Coated Materials, Biocompatible; D004338:Drug Combinations; D005404:Fixatives; D009829:Oleic Acids; D012997:Solvents; D013501:Surface-Active Agents; D013193:Stainless Steel; D000077410:Aluminum Chloride; D000431:Ethanol; C088318:2-(amino)oleic acid; D002118:Calcium; D005976:Glutaral