JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Trowbridge, E. A.
Right arrow Articles by Roberts, K. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Trowbridge, E. A.
Right arrow Articles by Roberts, K. M.

The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 577-585, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Pericardial heterografts: why do these valves fail?

EA Trowbridge, PV Lawford, CE Crofts and KM Roberts
Department of Medical Physics and Clinical Engineering, University of Sheffield, Royal Hallamshire Hospital, England.

Eighteen explanted pericardial heterografts were studied (16 standard Ionescu-Shiley, one Hancock, and one Mitroflow). Regurgitation was the reason given for explantation of all the Ionescu-Shiley valves. The other two valves were removed for technical reasons. All the Ionescu- Shiley valves had commissural tears and there was concomitant gross calcification in 10 of the 16 valves. In addition, an apparent increase in cusp area had caused "leaflet sagging". The explanted leaflets were thicker and stiffer than leaflets from an unimplanted valve. These features were confirmed directly with an animal model of subcutaneous implantation. Examination with an electron microscope revealed that these changes in mechanical properties seemed to be linked to fiber separation and infiltration by an amorphous proteinlike matrix. The durability of the glutaraldehyde-fixed pericardium depended on a number of factors. Early and midterm failure appeared to be stress induced. Predisposition to high mechanical stresses near the stent was exacerbated by the changes induced by the host environment. This problem was aggravated further in the Ionescu-Shiley valves by stress concentrations around the hole associated with the holding suture. In the long term, collagen disruption associated with leaflet flexure was followed by secondary calcification at the boundary between the intact and disrupted material.


This article has been cited by other articles:


Home page
 J Biomater ApplHome page
J. M. Garcia Paez, A. Carrera, A. Cordon, E. Jorge-Herrero, A. Rocha, J. Salvador, J. Mendez, J. L. Castillo-Olivares, I. Millaan, and N. Sainz
Uniaxial and Biaxial Tensile Strength of Calf Pericardium Used in the Construction of Bioprostheses: Biomaterial Selection Criteria
J Biomater Appl, July 1, 2000; 15(1): 47 - 64.
[Abstract] [PDF]

Home page
 CirculationHome page
T. Le Tourneau, C. Savoye, E. P. McFadden, D. Grandmougin, H.-F. Carton, J.-L. Hennequin, A. Dubar, G. Fayad, and H. Warembourg
Mid-Term Comparative Follow-Up After Aortic Valve Replacement with Carpentier-Edwards and Pericarbon Pericardial Prostheses
Circulation, November 9, 1999; 100(90002): II-11 - 16.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Penta de Peppo, J. Zeitani, R. De Paulis, and L. Chiariello
Autograft from quadrangular resection for floppy valve repair in endocarditis
Ann. Thorac. Surg., July 1, 1998; 66(1): 270 - 271.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1988 by The American Association for Thoracic Surgery.