Glutaraldehyde fixation revisited.
Our ability to stabilize animal heart valves and to manufacture equivalent prostheses using collagenous tissues has proven to be of significant value to large number of patients over the last 30 years. Such tissue-derived bioprostheses are being gradually improved by modifications of design and slight changes in the processing of the tissues from which they originate. Nevertheless their durability does not seem to have significantly improved, and some of their drawbacks, such as their propensity to calcify, have not been eliminated. Because of this children are excluded from receiving such implants. Enhancing such structures using cells from various sources or with the aid of growth factors does not seem likely to succeed because such inert matrices are not compatible with growth and remodeling. On the other hand, stabilizing these structures by means of novel crosslinking approaches, the addition of "plasticizing" molecules, or the addition of covalently bound residues that inhibit the growth of mineral deposits, could prove to be practical ways of improving such devices.
Nimni
M E
ME
Departments of Surgery, Orthopedics and Biochemistry and Molecular Biology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. nimni007@cs.com
D000818:Animals; D001705:Bioprosthesis; D002114:Calcinosis / Q000517:prevention & control*; D003094:Collagen / Q000378:metabolism; D003432:Cross-Linking Reagents / Q000494:pharmacology*; D005404:Fixatives / Q000494:pharmacology*; D005976:Glutaral / Q000494:pharmacology*; D006349:Heart Valve Diseases / Q000209:etiology / Q000517:prevention & control*; D006350:Heart Valve Prosthesis; D006801:Humans; D011474:Prosthesis Design
D003432:Cross-Linking Reagents; D005404:Fixatives; D003094:Collagen; D005976:Glutaral