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An Innovative Bovine Pericardial Treatment To Prevent Mechanical Damage In Bioprosthetic Heart Valves
Sotirios Korossis1, Antonio Maria Calafiore2, Axel Haverich3.
1Loughborough University, Loughborough, United Kingdom, 2Henry Dunant Hospital, Athens, Greece, 3Hannover Medical School, Hannover, Germany.

OBJECTIVE: Early structural bioprosthetic heart valve (BHV) degeneration involves active and passive mechanisms. While the active mechanisms are triggered by early host-response, passive deterioration is related to graft fatigue resulting in tearing and leaflet abrasion. Commercial BHVs do not constitute a viable tissue and, thus, are not capable of matrix regeneration and remodeling so any changes in the collagen meshwork (delamination, structural rearrangements) resulting from cyclic loading constitute irreversible damage. Prolonged cyclic loading during accelerated wear testing, highlighted a marked decrease in radial extensibility due to the stiffening of the collagen network, causing anomalies in stress distribution. Such condition leads to stress concentrations, especially in the bending and suture areas, generating a high BHV failure risk. The FACTAŽ technology has shown a protective biomechanical effect on glutaraldehyde (GLU) bovine pericardial treated tissues.
METHODS: Bovine pericardial strips (n=72) were crosslinked with 0.6% of GLU solution; 36 of the strips were treated with the FACTAŽ technology, the remaining were used as control (GLU; n=36). Each strip was mounted on a Thumler Z3-X500 uniaxial tensile tester equipped with a 100N load cell. The testing evaluated the ultimate tensile strength (UTS), elongation and Young's Modulus (YM).
RESULTS: No statistically significant difference was found between the FACTAŽ treated and untreated (GLU) strips regarding the UTS . The FACTAŽ group showed a significant increase in the Elongation and decrease in the YM.
CONCLUSIONS: The increased extensibility, manifested by the increased Elongation and decreased YM, allows for a better stress distribution, especially in the BHV areas subjected to greater loading. The FACTAŽ technology exerts a corrective effect against the decreased extensibility of the GLU-treated BHV tissue, and protects against the formation of tears and abrasion, by preserving the collagen structure and the proper functionality of the BHVs leaflets.


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