title: Physiological performance of a detergent decellularized heart valve implanted for 15 months in Vietnamese pigs: surgical procedure, follow-up, and explant inspection.
abstract: This study features the longest experimental follow-up for decellularized heart valves implanted in an animal model. Porcine aortic heart valves were decellularized according to a disclosed standardized method in which TRITON X-100 and sodium cholate (TRICOL) are used in succession, followed by a further treatment with the endonuclease Benzonase to completely remove the nucleic acid remnants. Experimental animals (n = 17), represented by Vietnamese pigs (VPs), received a decellularized aortic allograft as a substitute for the replacement of their right ventricular outflow tract. The surgical implantation of the TRICOL-treated aortic valve conduit was successful in 11 VPs, while perioperative or postoperative complications occurred in the remaining six animals. In the sham-operated group (n = 4), the native pulmonary root was excised and immediately reimplanted orthotopically in the same animal. Echocardiography demonstrated a satisfactory hemodynamic performance of the TRICOL-treated valves during follow-up as well as the absence of relevant leaflet alterations concerning thickness and motility or valve insufficiency. At explantation, macroscopic inspection of tissue-engineered heart valve conduits did not evidence calcifications and showed a decreased wall thickness, comparable to that of the reimplanted native pulmonary roots. Noteworthy, extended functional performance, recovery of DNA content, and active extracellular matrix precursor incorporation are apparently compatible with the properties of a living self-supporting substitute.
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Science, University of Padova, 2 via Giustiniani, Padua, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gallo
authors.forename: Filippo
authors.initials: F
authors.lastname: Naso
authors.forename: Helen
authors.initials: H
authors.lastname: Poser
authors.forename: Antonio
authors.initials: A
authors.lastname: Rossi
authors.forename: Paolo
authors.initials: P
authors.lastname: Franci
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco
authors.forename: Matteo
authors.initials: M
authors.lastname: Micciolo
authors.forename: Fabio
authors.initials: F
authors.lastname: Zanella
authors.forename: Umberto
authors.initials: U
authors.lastname: Cucchini
authors.forename: Luca
authors.initials: L
authors.lastname: Aresu
authors.forename: Edward
authors.initials: E
authors.lastname: Buratto
authors.forename: Roberto
authors.initials: R
authors.lastname: Busetto
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gandaglia
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D003902:Detergents / Q000737:chemistry; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006025:Glycosaminoglycans / Q000378:metabolism; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006351:Heart Valves / Q000502:physiology* / Q000601:surgery* / Q000648:ultrastructure; D008297:Male; D017830:Octoxynol / Q000737:chemistry; D011182:Postoperative Care; D020358:Sodium Cholate / Q000737:chemistry; D013552:Swine; D023822:Tissue Engineering / Q000379:methods
chemical_list: D003902:Detergents; D006025:Glycosaminoglycans; D017830:Octoxynol; D020358:Sodium Cholate