title: Degenerative Calcification of Pericardial Bioprostheses: Comparison of Five Implantation Methods in a Rabbit Model.
abstract: OBJECTIVE
  The degenerative calcification of bioprosthetic heart valves remains a clinical challenge, especially among young adults and children. Animal models that are based on subcutaneous and intramuscular implantation and are typically used to assess interventions to prevent bioprosthetic heart valve calcification do not reflect actual hemodynamic stress and lack direct blood contact. Thus, the study aim was to investigate bioprosthesis calcification at different implantation sites.
  
  
  METHODS
  The calcification degrees of five valve implantation methods, namely subcutaneous, intramuscular and intravenous implantation, and arterial and venous patch angioplasty, were simultaneously investigated in 10 New Zealand White rabbits.
  
  
  RESULTS
  Ultrasonography and computed tomography images showed vascular patency to be well maintained in all implanted vessels. Histologically, cellular infiltrates around the implant and within the collagen fibers were only found in the intravenous implantation group, which also had the highest calcium level among the methods.
  
  
  CONCLUSIONS
  The present study was the first to compare the degree of calcification after applying five implantation methods simultaneously in one animal species. The rabbit intravenous implantation model, which involved direct contact with blood factors, is expected to serve as a useful animal model for research into the prevention of bioprosthetic heart valve degeneration.
authors.forename: Dai-Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Han Ki
authors.initials: HK
authors.lastname: Park
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Hyun-Chel
authors.initials: HC
authors.lastname: Joo
authors.forename: Sak
authors.initials: S
authors.lastname: Lee
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Youn
authors.forename: Hong Ju
authors.initials: HJ
authors.lastname: Shin
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery; D006349:Heart Valve Diseases / Q000209:etiology* / Q000473:pathology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D064593:Heterografts; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000473:pathology / Q000601:surgery; D010496:Pericardium / Q000473:pathology / Q000637:transplantation*; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D011817:Rabbits; D040521:Subcutaneous Tissue / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color