Prevention of calcification in bovine pericardial bioprosthesis cyxretreatment with surfactants

Ahnn, Jae Ho; Han, Jae Jin; Park, Sung Soo

Abstract

BACKGROUND: Bovine pericardial bioprosthesis treated with glutaraldehyde (GA) is one of the most popular prosthetic materials, but late calcific degeneration after implantation is a problem that remains unsolved. For the purpose of mitigating the calcific degeneration, we added MgCl2 into the 0.625% GA solution to compete with calcium for binding to the free aldehyde from GA and pretreated with the surfactants like sodium dodecyl sulfate (SDS) and Triton X-100 before GA fixation for preventing the phospholipid infiltration into the pericardial tissue, the first step of the calcific degeneration. MATERIAL AND METHOD: 40 square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl2 6H2O as a control group (group 1). 40 pieces pretreated with 1% SDS were also fixed in the same GA solution (group 2) and other 40 pieces pretreated with 1% Triton X-100 were prepared with the same method (group 3). After 1 month of fixation these were implanted into the belly of 40 Sprague-Dawley subdermally and extracted 1 month, 2 months, 3 months and 6 months after implantation. With atomic absorption spectrophotometry we measured the deposited calcium amount. RESULT: 1 month after implantation we could not find any differences between the three groups, but by the 2nd month calcium deposition was 0.921+/-0.121 mg/g in group 1, 0.481+/-0.037 mg/g in group 2 and 1.369+/-0.200 mg/g in group 3. By the 3rd month it was 0.786+/-0.080 mg/g in group 1, 0.584+/-0.054 mg/g in group 2 and 1.139+/-0.188 mg/g in group 3, and on the 6th month 1.623+/-0.601 mg/g in group 1,0.501+/-0.043 mg/g in group 2 and 1.625+/-0.382 mg/g in group 3, with statistical significance in group 2 (p<0.05).
CONCLUSION
Pretreatment with SDS showed meaningful calcium mitigation effects on subcutaneously implanted bovine pericardium in the rat models but the neutral type surfactant, Triton X-100, had no positive mitigation effect in this experiment.