Effectiveness of Different Anticalcification Treatments for Stentless Aortic Bioprostheses

Abstract

Background: New anticalcification treatments for stentless bioprostheses have not yet been compared independently. Material and Methods: The No-react® (Biocor), AOA® (Medtronic Freestyle), and BiLinx^™ (SJM Toronto SPV II) methods were studied and compared with a control group. Aortic valve leaflet and aortic root tissue was subcutaneously implanted in 60 male, 21-days-old Sprague-Dawley rats. Calcium content was quantified using inductively coupled plasma spectrophotometry. Results: No infections occurred. Low levels of calcium were measured in aortic valve leaflet tissue for all methods (0.4 to 1.5 mg/g dry weight) in comparison to the control group (225 mg/g), p <0.01. Calcification of aortic root tissue was low in the Bilinx^™ group (2.4 mg/g, p < 0.01 ), whereas calcium levels were high in all other groups (104 to 127 mg/g). Conclusions: Calcification of aortic valve leaflets was significantly reduced by all new anticalcification treatments, whereas aortic root calcification was only reduced by inhibition of cellular calcification (BiLinx^™). Maximum anticalcification properties of both leaflet and aortic root are important, as these are considered a functional unit in stentless bioprostheses.

Key words

Stentless bioprostheses - Anticalcification treatment - Experimental comparison