Objective: : Most commercially available bioprosthetic valves are stored in an aldehyde solution. We report a new alternative method: Self-expanding valves composed of dehydrated tissues with a high glycerin:water ratio can be collapsed into specially designed sheaths prior to sterilization for ease of delivery and storage.
Materials And Methods: : Changes in tissue dimension of five samples of bovine pericardium were evaluated from baseline after glycerol treatment, air-drying, ethylene oxide (EtO) sterilization, and rehydration with water. Three valves fabricated from glutaraldehyde cross-linked tissues, including porcine pericardial tissue, bovine pericardial tissue, and porcine aortic valve, were dehydrated through a proprietary glycerin-based process, collapsed, placed within a catheter, EtO sterilized, stored for up to 212 days, and rehydrated with water. These valves were characterized in a mock circulation by mounting them at the inlet portion of a pneumatic pump before dehydration and after rehydration to evaluate the effects of dehydration and rehydration on the valve performance.
Results: : Tissues treated with glycerol solution showed no significant changes in dimension from baseline after glycerol treatment, air-drying, EtO sterilization, and rehydration with water. In all the valves, pump flows reached the maximum output capacity of the pneumatic pump after rehydration without an increase in filling pressures as compared with those before dehydration.
Conclusions: : This method for storing collapsible bioprosthetic valves using a proprietary glycerin-based process demonstrated excellent valve performance.
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http://dx.doi.org/10.1097/IMI.0b013e31820a7cd6 | DOI Listing |
J Mech Behav Biomed Mater
December 2024
Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 2, Dublin, Ireland; Discipline of Mechanical, Manufacturing, and Biomedical Engineering, School of Engineering, Trinity College Dublin, 2, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), Trinity College Dublin, Ireland. Electronic address:
Aortic stenosis is a prevalent disease that is treated with either mechanical or bioprosthetic valve replacement devices. However, these implants can experience problems with either functionality in the case of mechanical valves or long-term durability in the case of bioprosthetic valves. To enhance next generation prosthetic valves, such as biomimetic polymeric valves, an improved understanding of the native aortic valve leaflet structure and mechanical response is required to provide much needed benchmarks for future device development.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Adult Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.
This report presents the case of a 66-year-old man with acute torrential aortic insufficiency after a Ross procedure 20 years earlier, a biologic aortic valve replacement 16 years earlier, and a transcatheter valve-in-valve 4 years earlier. He underwent third-time sternotomy, revealing that the pulmonary autograft was heavily calcified and frozen to the homograft. The previous transcatheter valve-in-valve was explanted.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Continuous retrograde flow across the aortic valve from left ventricular assist device (LVAD) therapy can result in cusp damage and progressive aortic regurgitation, potentially triggering recurrent heart and multiorgan failure. The management of aortic regurgitation after LVAD implantation has not been well defined.
Methods: This study retrospectively reviewed the investigators' experience with the management of de novo aortic regurgitation requiring intervention in patients with continuous-flow LVAD.
Ann Thorac Surg Short Rep
June 2024
University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
Background: Comparative studies of outcomes between different biological mitral valve prostheses are scarce. This study compares the late clinical results of valve replacement with the Epic and Mosaic bioprostheses.
Methods: Patients undergoing isolated elective mitral valve replacement (MVR) between 2005 and 2019 were eligible for inclusion.
Ann Thorac Surg Short Rep
June 2024
Department of Cardiovascular Surgery, Adult, Sakakibara Heart Institute, Tokyo, Japan.
A 38-year-old woman underwent minimally invasive aortic valve replacement with a 21-mm Inspiris aortic valve and Cor-Knot for type 0 bicuspid valve and severe aortic stenosis. Postoperative transthoracic echocardiography was uneventful. Four months later, she experienced shortness of breath.
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