Prevention of tissue calcification on bioprosthetic heart valve by using epoxy compounds: A study of calcification tests in vitro and in vivo

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Abstract
Calcification is the principal cause of the clinical failures of the bioprosthetic heart valves fabricated from glutaraldehyde pretreated porcine aortic valves or bovine pericardium. In this paper, we compared the calcification on various types of bovine pericardiums pretreated with two hydrophilic epoxy compounds adding GA post-treatment (EP 1 and EP 2), glutaraldehyde (GA)- and nontreated pericardium (Fresh), respectively, by in vitro and in vivo tests. Significant decrease of calcification was found by pretreatment with both epoxy compounds rather than with glutaraldehyde : 0.250 ± 0.001 (Fresh), 0.276 ± 0.058 (EP l), 0.302 ± 0.071 (EP 2), and 0.478 ± 0.172 (GA) μg (Ca)/mg (dried tissue), respectively, after 20 days dipping in a simulating serum solution in vitro; 115.13 ± 60.11 (Fresh), 129.84 ± 51.08 (EP 1), 167.39 ± 20.81 (EP 2), and 205.19 ± 16.86 (GA) pg/mg, respectively, after 3 months subcutaneous implantation i n rabbits. The in uifro method for evaluating calcification designed by us gave the similar order among four samples with that obtained by in uiuo test. Because the bovine pericardium pretreated with the epoxy compounds adding GA post treatment possesses the greater tenacity than that pretreated only with epoxy compounds or GA, meanwhile the calcification is also significantly decreased with this pretreatment, it may be expected that the bovine pericardium with this pretreatment will have the greater anticalcification and durability in dynamic stress. © 1992 John Wiley & Sons, Inc.

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