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Calcification of Cardiac Valve Bioprostheses

Host and Implant Factors

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Calcium in Biological Systems

Abstract

Glutaraldehyde-preserved stent-mounted porcine aortic valve bioprostheses are widely used in the surgical management of valvular heart disease [3,13,16,17]. Since 1971, several hundred thousand have been implanted in patients undergoing cardiac valve replacement. In most cases, bioprostheses offer the distinct advantages of freedom from chronic anticoagulation and favorable hemodynamic performance. However, calcification of bioprostheses is frequent after long-term function [16,17]. Mineral deposits often lead to clinically significant valvar dysfunction, which usually necessitates reoperation, but is occasionally fatal.

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References

  1. Barnhardt, G. R.; Jones, M.; Ishihara, T.; Rose, D.; Chavez, A. M.; Ferrans, V. J. Degeneration and calcification of bioprosthetic cardiac valvesAm. J. Pathol 106: 136–139, 1982.

    Google Scholar 

  2. Bowes, J. H.; Carter, C. W. The interaction of aldehydes with collagenBiochim, Biophys. Acta 168: 341–352, 1968.

    CAS  Google Scholar 

  3. Carpentier, A.; Lemaigre, G.; Robert, L.; Carpentier, S.; DuBost, C. Biological factors affecting long term results of valvular heterograftsJ. Thorac. Cardiovasc. Surg 58: 467–483, 1969.

    PubMed  CAS  Google Scholar 

  4. DeLuca, H. F.; Schnoes, H. K. Metabolism and mechanism of action of vitamin D. Annu. Rev. Biochem 45: 631–666, 1977.

    Article  Google Scholar 

  5. Ferrans, V. J.; Boyce, S. W.; Billingham, M. E.; Jones, M.; Ishihara, T.; Roberts, W. C. Calcific deposits in porcine bioprostheses: Structure and pathogenesisAm. J. Cardiol 46: 721–734, 1980.

    Article  PubMed  CAS  Google Scholar 

  6. Fishbein, M.; Levy, R. J.; Nashef, A.; Ferrans, V. J.; Dearden, L. C.; Goodman, A. P.; Carpentier, A. Calcification of cardiac valve bioprostheses: Histologic, ultrastructural, and biochemical studies in a subcutaneous implantation model systemJ. Thorac. Cardiovasc. Surg 83: 602–609, 1982.

    PubMed  CAS  Google Scholar 

  7. Hauschka, P. V.; Lian, J. B.; Gallop, P. M. Direct identification of the calcium binding amino acid, 7- carboxyglutamate, in mineralized tissueProc. Natl. Acad. Sci. USA 72: 3925–3929, 1975.

    Article  PubMed  CAS  Google Scholar 

  8. Levy, R. J.; Gundberg, C.; Scheinman, R. The identification of the vitamin K-dependent bone protein, osteocalcin as one of the 7-carboxyglutamic acid containing proteins present in calcified atherosclerotic plaque and mineralized heart valvesAtherosclerosis 46: 49–56, 1983.

    Article  PubMed  CAS  Google Scholar 

  9. Levy, R. J.; Schoen. F. J.; Howard, S. L. Calcification of porcine bioprosthetic aortic valve leaflets is not mediated by immunological processesAm. J. Cardiol 52: 829–831, 1983.

    Article  Google Scholar 

  10. Levy, R. J.; Schoen, F. J.; Levy, J. T.; Nelson, A. C.; Howard, S. L.; Oshry, L. J. Biological determinants of dystrophic calcification and osteocalcin deposition in glutaraldehyde-preserved porcine aortic valve leaflets implanted in glutaraldehyde-preserved porcine aortic valve leaflets implanted subcutaneously in ratsAm. J. Pathol 113: 143–155, 1983.

    PubMed  CAS  Google Scholar 

  11. Levy, R. J.; Zenker, J. A.; Bernhard, W. F. Porcine bioprosthetic valve calcification in bovine left ventricle to aorta shunts: Studies of the deposition of vitamin K-dependent proteinsAnn. Thorac. Surg 36: 187–192, 1983.

    Article  PubMed  CAS  Google Scholar 

  12. Levy, R. J.; Zenker, J. A.; Lian, J. B. Vitamin K-dependent calcium binding proteins in aortic valve calcificationJ. Clin. Invest 65: 563–566, 1980.

    Article  Google Scholar 

  13. Oyer, P. E.; Miller, D. C.; Stinson, E. B.; Reitz, B. A.; Moreno-Carbral, R. J.; Shumway, N. E. Clinical durability of the Hancock porcine bioprosthetic valveJ. Thorac. Cardiovasc. Surg 82: 127–137, 1980.

    Google Scholar 

  14. Price, P. A.; Williamson, M. K.; Haba T.; Dell, R. B.; and Jee, W. S. S. Excessive mineralization with growth plate closure in rats on chronic warfarin treatmentProc. Natl. Acad. Sci. USA 79: 7734–7738, 1982.

    Article  PubMed  CAS  Google Scholar 

  15. Round, J. M. Plasma calcium, magnesium, phosphorus, and alkaline phosphtase in normal British school childrenBr. Med. J 3: 137–140, 1972.

    Google Scholar 

  16. Sanders, S. P.; Levy, R. J.; Freed, M. D.; Norwood, W. I.; Castaneda, A. R. Use of Hancock porcine xenografts in children and adolescentsAm. J. Cardiol 46: 429–438, 1980.

    Article  PubMed  CAS  Google Scholar 

  17. Schoen, F. J.; Collins, J. J.; Cohn, L. H. Long-term failure rate and morphologic correlations in porcine bioprosthetic heart valvesAm. J. Cardiol 51: 957–964, 1983.

    Article  PubMed  CAS  Google Scholar 

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© 1985 Plenum Press, New York

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Levy, R.J., Schoen, F.J., Howard, S.L., Levy, J.T., Oshry, L., Hawley, M. (1985). Calcification of Cardiac Valve Bioprostheses. In: Rubin, R.P., Weiss, G.B., Putney, J.W. (eds) Calcium in Biological Systems. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2377-8_72

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  • DOI: https://doi.org/10.1007/978-1-4613-2377-8_72

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9453-5

  • Online ISBN: 978-1-4613-2377-8

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