Document Detail

New aspects of the degeneration of bioprosthetic heart valves after long-term implantation.
MedLine Citation:
PMID:  1614200     Owner:  NLM     Status:  MEDLINE    
Bioprosthetic heart valves removed 76 to 150 months after implantation were morphologically investigated to correlate structural alterations with clinical failure modes. Traditional morphologic methods of evaluating valvular heterografts, such as microradiography and electron microscopy, were complemented by undecalcified ground sections, a new technique for analyzing the distribution of mineral deposits. Apart from well-investigated mechanisms that accelerate tissue degeneration, our observations point to additional facts: (1) phagocytosis of collagen fibrils and elastic material by macrophages and foreign body giant cells in areas near tears and perforations and (2) initial calcification indicated by delicate crystals in the intercellular space arranged in close relation to the periodicity of the cross-striation pattern of collagen fibrils. The present report not only calls attention to degenerative changes that are enhanced by mechanical stress but also underlines phagocytosis as an important mechanism in the destruction of bioprosthetic heart valves.
M Grabenwöger; M Grimm; E Eybl; M Kadletz; M Havel; P Köstler; H Plenk; P Böck; E Wolner
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  104     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-07-30     Completed Date:  1992-07-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  14-21     Citation Subset:  AIM; IM    
Second Department of Surgery, University of Vienna, Austria.
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MeSH Terms
Calcinosis / pathology
Collagen / analysis
Foreign-Body Reaction / pathology
Giant Cells, Foreign-Body / physiology*
Heart Valve Diseases / surgery*
Heart Valve Prosthesis*
Macrophages / physiology*
Microscopy, Electron
Middle Aged
Prosthesis Failure
Stress, Mechanical
Time Factors
Reg. No./Substance:

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