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J Thorac Cardiovasc Surg 1997;113:302-310
© 1997 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

VISCOELASTICITY OF DYNAMICALLY FIXED BIOPROSTHETIC VALVES. II. EFFECT OF GLUTARALDEHYDE CONCENTRATION

Supported in part by a grant from the Medical Research Council of Canada (MRC). Dr Anthony C. Duncan was supported by a postdoctoral fellowship from the MRC, Dr. D. Boughner is a Research Associate at the Heart and Stroke Foundation of Ontario, Canada, and Dr. I. Vesely is a Research Scholar of the Foundation.

Received for publication April 2, 1996 revisions requested May 22, 1996; revisions received Sept. 27, 1996 accepted for publication Oct. 8, 1996. Address for reprints: Anthony C. Duncan, J. P. Robarts Research Institute, 100 Perth Dr., PO Box 5015, London, Ontario, N6A 5K8 Canada.

Abstract

Objectives: We have previously shown the benefits of dynamic fixation over conventional static fixation of bioprosthetic valves. In an attempt to increase the durability of bioprosthetic heart valves, we explored the benefit of low-concentration glutaraldehyde dynamic fixation.Methods: Pig aortic valves obtained fresh from the abattoir and excised with the entire root were dynamically fixed in glutaraldehyde phosphate buffer solutions varying in concentration from 0.05% to 2.5%. Denaturation temperatures were measured and mechanical testing was performed at low (3 mm/sec) to high physiologic rates (30 mm/sec) at 37° C in isotonic modified Hanks solution.Results: When fixed dynamically in 0.05% glutaraldehyde solution for 24 hours, the tissue reached a degree of cross-linking (denaturation temperature = 82.8° ± 0.6° C) significantly higher than that obtained for 0.05% static fixation (denaturation temperature = 79.3° ± 0.9° C) (p < 0.05) but similar to that for conventional static fixation in 0.5% glutaraldehyde solution (denaturation temperature = 83.5° ± 0.3° C). After fixation in low-concentration glutaraldehyde (0.05%), final relaxation slopes and moduli in the circumferential direction were significantly higher than those for the statically fixed tissue but similar to those for the fresh tissue. However, both dynamic and static fixation had the effect of increasing tissue extensibility to similar extents in both directions, irrespective of glutaraldehyde concentration.Conclusion: Dynamic glutaraldehyde fixation of a porcine aortic valve at lower concentrations resulted in a better degree of cross-linking and a material with biomechanical properties that more closely mimic those of natural heart valve tissue. (J thorac Cardiovasc Surg 1997;113:302-10)

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