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The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 215-224, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
G Thiene, F Laborde, M Valente, O Bical, E Talenti, U Bortolotti and P Gallix
The effectiveness of a water-soluble C-12 alkyl sulfate (T6) (U.S. Patent
No. 4,323,358) in retarding bioprosthetic calcification was evaluated in 23
porcine-valved conduits (13 T6-treated conduits and 10 controls) implanted
in young sheep between the right ventricle and the pulmonary trunk. The
grafts were divided into three groups according to the period of function:
Group I, less than 2 months; Group II, 2 to 4 months; and Group III, 5 to 7
months. In Group I (four T6 and four controls), endocarditis occurred in
five cases. In Group II (three T6 and three controls), four conduits showed
severe fibrous peel ingrowth. In Group III (six T6 and three controls),
fibrous peel was the main feature in four conduits and calcium deposits
occurred in the porcine aortic wall in all cases, with cusp involvement in
two; in both T6- treated and control conduits, chemical analysis showed a
much lower calcium content of the cusps (8.45 +/- 80 versus 2.95 +/- 1.52
mg/gm dry weight, respectively) than that reported in other animal or human
explants. The grade of calcification in control and T6-treated conduits was
equal on x-ray analysis, and no differences in calcification patterns were
noted on electron microscopy. This experimental model shows a low degree of
cusp calcification and no significant differences between T6-treated and
control conduits. Peel formation markedly interferes with performance of
the porcine-valved conduit. The results of this analysis indicate that
valved conduits are not the optimum model for evaluating calcium-retardant
agents in biological valves.
ARTICLES
Experimental evaluation of porcine-valved conduits processed with a calcium-retarding agent (T6)
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