title: The influence of chemical treatment and suture on the elastic behavior of calf pericardium utilized in the construction of cardiac bioprostheses.
abstract: Poor mechanical properties of biological tissue are known to cause wear, leading to the failure of cardiac bioprostheses made of calf pericardium. Different chemical agents such as sodium dodecyl sulfate (SDS) are presently being tested as possible inhibitors of the calcification process. The objective of this report was to determine the mechanical behavior of calf pericardium treated with SDS for 24 h and the influence of the suture on the mechanical properties of the tissue. Forty-eight samples were tested: 24 subjected to a standard treatment with glutaraldehyde (12 sewn with 4/0 silk suture thread) and 24 incubated with SDS for 24 h (12 sewn with the same suture thread). Each sutured and non-sutured sample was cut into two strips to yield paired samples. All were subjected to tensile stress to breaking point. The mean stress at breaking point in the non-sutured series treated with glutaraldehyde alone was 16.42 and 13.85 MPa depending on the region of the pericardium, while in the sutured samples subjected to glutaraldehyde the mean stress was 7.50 and 7.63 MPa, respectively, differences which were statistically significant (p = 0.03 and p = 0.003, respectively) when the means for non-sutured samples from equivalent regions treated with glutaraldehyde were compared. The stress at breaking point was lower in the SDS-treated series, ranging between 2.60 and 3.56 MPa. The mathematical functions that govern the stress/strain or deformation were obtained. In the series of pericardium treated with SDS, deformations of 10% were produced with stresses of under 0.4 MPa, an outcome that is intolerable from the constructive point of view. We established a regression model that enabled us to determine the mechanical behavior of a sutured sample by testing a contiguous piece of tissue, with a high correlation coefficient (r \gt 0.99). We consider this finding to be of interest in the selection of pericardium for use in the construction of leaflets for cardiac bioprostheses.
authors.affiliation: Servicio de Cirugía Experimental, Clínica Puerto de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: García Páez
authors.forename: E J
authors.initials: EJ
authors.lastname: Herrero
authors.forename: A
authors.initials: A
authors.lastname: Carrera San Martín
authors.forename: J V
authors.initials: JV
authors.lastname: García Sestafe
authors.forename: G
authors.initials: G
authors.lastname: Téllez
authors.forename: I
authors.initials: I
authors.lastname: Millán
authors.forename: J
authors.initials: J
authors.lastname: Salvador
authors.forename: A
authors.initials: A
authors.lastname: Cordón
authors.forename: J L
authors.initials: JL
authors.lastname: Castillo-Olivares