Refinement of the Alpha Aminooleic Acid Bioprosthetic Valve Anticalcification Technique英文电子书.pdf

Refinement of the Alpha Aminooleic Acid Bioprosthetic Valve Anticalcification Technique John Parker Gott, MD, Marie-Nadia Girardot, PhD, Jean-Marie D. Girardot, PhD, James D. Hall, MD, Joseph D. Whitlark, MD, W. Stewart Horsley, MD, Lynne M. A. Dorsey, MBA, Robert J. Levy, MD, Weiliam Chen, PhD, Frederick J. Schoen, MD, PhD, and Robert A. Guyton, MD Carlyle Fraser Heart Center, Crawford Long Hospital of Emory University, Emory University School of Medicine, and Biomedical Design, Inc, Atlanta, Georgia; University of Michigan Medical Center, Ann Arbor, Michigan; and Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts Background. Aminooleic acid treatment has been dem- dermal model were markedly less calcified than control onstrated to prevent porcine valve calcification and to cusps (AOA II, 1 0, 17 4, 23 6, and 17 10 versus protect valvular hemodynamic function. Initial enthusi- control, 189 14, 251 16, 250 14, and 265 10 mg asm was tempered by histologic studies of these AOA calcium/mg sample at 4, 8, 12, and 16 weeks, respectively; valves, which showed cuspal hematomas, structural loos- p 0.0001). Morphologic examination of the AOA II ening, and surface roughening. This prompted a system- cusps of the valves retrieved from the sheep demon- atic review of the AOA treatment process. Unsolubilized strated freedom from the structural loosening, surface particles of alpha aminooleic acid present in the treat- roughening, and hematoma formation that had limited ment solution were identified as the cause of mechanical the utility of the original AOA preparation technique. abrasion of valve cusps during processing. These parti- Cusps from AOA II-treated porcine roots had signifi- cle