Document Detail


Early failure of an autologous pericardium aortic heart valve (ATCV) prosthesis.
MedLine Citation:
PMID:  9502136     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS OF THE STUDY: The risk of reoperation due to calcific degeneration is the most important drawback of biological heart valves compared with mechanical prostheses. Concepts to mitigate calcification have been tested experimentally and clinically, but none has proven completely to prevent degeneration. METHODS: Renewed interest has involved the use of autologous pericardium for intraoperative construction of autologous aortic valves (ATCV). RESULTS: Of 10 ATCV implanted between 1994 and 1996, one was removed from an 84-year-old female 27 months after implantation because of severe valvular insufficiency. Eight months earlier, a broken spring of the stent system was detected radiographically, with normal valvular competence at echocardiography. Valve dysfunction was due to shrinkage of one leaflet. Measurement of tissue calcium by atomic absorption spectroscopy showed high levels in the shrunken leaflet compared with two intact leaflets (42.82 versus 0.51 and 2.42 mg Ca2+/g). Histology and immunohistology demonstrated extensive fiber degeneration without inflammation or immune reactions in the destroyed leaflet, and moderate fiber degeneration in intact leaflets. Scanning electron microscopy showed smooth surfaces in the normal leaflet and exposure of collagen in the degenerated leaflet in association with calcium deposition. CONCLUSIONS: In contrast to the outcome in animal studies, intraoperative tanning did not prevent tissue shrinkage in this case. Leaflet malfunction was associated with calcification. At present, the clinical use of valves constructed from autologous pericardium can not be recommended.
Authors:
M Dahm; D Prüfer; E Mayer; E Groh; Y H Choi; H Oelert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  7     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-04-23     Completed Date:  1998-04-23     Revised Date:  2006-05-04    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  30-3     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve
Bioprosthesis*
Calcinosis / etiology
Female
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation
Humans
Prosthesis Failure
Stents
Time Factors
Transplantation, Autologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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