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Eur J Cardiothorac Surg 1999;15:134-142
© 1999 Elsevier Science NL

Calcification characteristics of porcine stentless valves in juvenile sheep¹

^a Center for Experimental Surgery and Anaesthesiology, Division of Experimental Cardiac Surgery, Provisorium I, Minderbroedersstraat 17, B-3000 Leuven, Belgium
^b Department of Pathology, K.U. Leuven, B-3000 Leuven, Belgium

Received 21 September 1998; received in revised form 7 December 1998; accepted 16 December 1998.

^* Corresponding author. Tel: +32-16-337298; fax: +32-16-337855.

Objective: To compare calcification characteristics of two porcine stentless valves (Toronto SPV and Freestyle) with different designs, fixation and antimineralization techniques using a juvenile sheep model of valve implantation inside the circulation. Methods: The stentless valves (n=2x6) were implanted in juvenile sheep in the pulmonary artery as an interposition, while the circulation was maintained with a right ventricular assist device. The model was validated by the implantation of, clinically well-known, porcine (Hancock II) and pericardial (Pericarbon) valves. Half of the valves were explanted after 3 months, the rest after 6 months. Valves were examined macroscopically, by X-ray, light microscopy (HE, Masson, Von Giesson, Von Kossa, PTAH stains), and transmission electron microscopy. Quantitative determination of the calcium content of the cusps was performed with atomic absorption spectrometry. Results: After 3 months, the Freestyle had an extensively calcified aortic wall, most prominent at the outflow side of the porcine valve. After 6 months, calcification increased transmurally, but the valve cusps were free of calcification, and the inflow side was only slightly calcified. The Toronto SPV valve also started to calcify at the inflow side of the valve after 3 months with increased calcification after 6 months. The base of the Toronto SPV valve cusps showed slight calcification after 6 months of implantation. Conclusions: The pattern of calcification of the porcine aortic wall differs between the two studied stentless valves, with calcification located predominantly at the outflow side in the Freestyle valve, but also at the inflow side in the Toronto SPV valve. The cusps of the Freestyle valve were less prone to calcification than those from the Toronto SPV valve.

Key Words: Experimental • Juvenile sheep • Stentless aortic valve • Bioprosthesis • Cardiac surgery • Calcification

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