This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Guido Van Nooten Kishan Narine Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Van Nooten, G. Articles by Narine, K. Search for Related Content PubMed PubMed Citation Articles by Van Nooten, G. Articles by Narine, K. Related Collections Valve disease

Acellular porcine and kangaroo aortic valve scaffolds show more intense immune-mediated calcification than cross-linked Toronto SPV^® valves in the sheep model

^a Department of Cardiac Surgery, 5K12, University Hospital Ghent, De Pintelaan 185, BE-9000 Ghent, Belgium
^b Veterinary Medicine, Ghent University, Ghent, Belgium
^c Histology and Human Anatomy, Ghent University, Ghent, Belgium
^d Department of Cardiac Surgery, The Prince Charles Hospital, University of Queensland, Brisbane, Australia

*Corresponding author. Tel.: +32 9 240 4700; fax: +32 9 240 3882.

E-mail address: guido.vannooten{at}ugent.be (G. Van Nooten).

Aim of the study: A major limitation of currently available bioprosthetic valves is their propensity to calcify. At present, one approach in tissue-engineering, uses decellularized, xenogenic scaffolds that are implanted, with the expectation of complete matrix repopulation in vivo. Whether or not such a decellularized matrix will be sufficiently endowed to prevent calcification is unknown. Materials and methods: This study examines the calcification potential of xenogenic biological scaffolds from two species, namely pigs (n=3) and kangaroos (n=3) in the sheep model and compared them to a commercially available glutaraldehyde treated porcine bioprosthetic valve (Toronto SPV^®) (n=3). Results: Valves and matrices were explanted after 120 days. Histologically (H&E and Von Kossa stain) more calcium was found in the acellular matrices. The mean calcium content (mg/g-dw) of the Toronto SPV^® valve leaflets was 2.63 mg/g-dw compared to 43.81 mg/g-dw (P=0.12) in kangaroo and 105.08 mg/g-dw (P=0.004) in porcine matrices. On electron microscopy calcific deposits were located between as well as in close association with the collagen fibers in all tissue. In contrast to the cross-linked gluteraldehyde fixed bioprostheses both matrices showed strong immune IgG reaction. Conclusion: Toronto SPV^® valves calcified significantly less than the tested biological matrices irrespective of species of origin. Surprisingly, xenogenic decelullarized scaffolds are inherently prone to calcification due to a strong immunogenecity.

Key Words: Xenogenic scaffolds; Cross-links; Calcification; Immune response