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. 1972 Jul;27(4):401–409. doi: 10.1136/thx.27.4.401

Pathology of the formalin-treated heterograft porcine aortic valve in the mitral position

Alan G Rose 1
PMCID: PMC469942  PMID: 4672718

Abstract

The mitral valve was replaced by a pig aortic valve in 33 patients at Groote Schuur Hospital. Eleven of the failed heterograft aortic valves were examined at intervals of from 2 to 32 months after insertion. Fourteen control pig aortic valves were also examined. Electron microscopy was performed on two of the failed heterograft valves and three control pig valves. Failure of the heterograft was due to stretching and deformation of the cusps with resultant valvular incompetence. Stretching of the cusp was a result of reduction in the amount of its collagen content. The elastic tissue appeared little altered. A microscopic layer of fibrin thrombus was present on the surface of 8 of the 11 valves. Only 2 of the 11 valves showed invasion of the graft by immunologically competent cells. No valve showed any sign of infection or calcification. The denatured collagen of the heterograft has a low antigenicity and also, infortunately, a limited durability.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Binet J. P., Duran C. G., Carpenter A., Langlois J. Heterologous aortic valve transplantation. Lancet. 1965 Dec 18;2(7425):1275–1275. doi: 10.1016/s0140-6736(65)92287-7. [DOI] [PubMed] [Google Scholar]
  2. Carpentier A., Lemaigre G., Robert L., Carpentier S., Dubost C. Biological factors affecting long-term results of valvular heterografts. J Thorac Cardiovasc Surg. 1969 Oct;58(4):467–483. [PubMed] [Google Scholar]
  3. Caulfield J. B., Page D. L., Kastor J. A., Sanders C. A. Connective tissue abnormalities in spontaneous rupture of chordae tendineae. Arch Pathol. 1971 Jun;91(6):537–541. [PubMed] [Google Scholar]
  4. Davies H., Missen G. A., Blandford G., Roberts C. I., Lessof M. H., Ross D. N. Homograft replacement of the aortic valve. A clinical and pathologic study. Am J Cardiol. 1968 Aug;22(2):195–217. doi: 10.1016/0002-9149(68)90226-9. [DOI] [PubMed] [Google Scholar]
  5. Gunning A. J., Meade J. B. Preservation and function of heterologous aortic valves. An experimental study. Thorax. 1971 Mar;26(2):179–183. doi: 10.1136/thx.26.2.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hirsch H. H. Persistence of aortic-valve homografts. Lancet. 1967 Jun 3;1(7501):1225–1226. doi: 10.1016/s0140-6736(67)92870-x. [DOI] [PubMed] [Google Scholar]
  7. Ionescu M. I., Wooler G. H., Whitaker W., Smith D. R., Taylor S. H., Hargreaves M. D. Heart valve replacement with reinforced aortic heterografts. Technique and results. J Thorac Cardiovasc Surg. 1968 Sep;56(3):333–350. [PubMed] [Google Scholar]
  8. Lazarus G. S., Daniels J. R., Brown R. S., Bladen H. A., Fullmer H. M. Degradation of collagen by a human granulocyte collagenolytic system. J Clin Invest. 1968 Dec;47(12):2622–2629. doi: 10.1172/JCI105945. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lincoln J. C., Riley P. A., Revignas A., Geens M., Ross D. N., Ross J. K. Viability of autologous fascia lata in heart valve replacements. Thorax. 1971 May;26(3):277–283. doi: 10.1136/thx.26.3.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. MONTFORT I., PEREZ-TAMAYO R. Studies on uterine collagen during pregnancy and puerperium. Lab Invest. 1961 Nov-Dec;10:1240–1258. [PubMed] [Google Scholar]
  11. Mohri H., Reichenbach D. D., Barnes R. W., Merendino K. A. A biologic study of the homologous aortic valve in dogs. J Thorac Cardiovasc Surg. 1967 Nov;54(5):622–628. [PubMed] [Google Scholar]
  12. O'Brien M. F., Clareborough J. K. Heterograft aortic-valve replacement. Lancet. 1967 Apr 29;1(7496):929–930. doi: 10.1016/s0140-6736(67)91491-2. [DOI] [PubMed] [Google Scholar]
  13. Pérez-Tamayo R. Collagen resorption in carrageenin granulomas. II. Ultrastructure of collagen resorption. Lab Invest. 1970 Feb;22(2):142–159. [PubMed] [Google Scholar]
  14. Smith J. C. The pathology of human aortic valve homografts. Thorax. 1967 Mar;22(2):114–138. doi: 10.1136/thx.22.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Welch W. A comparative study of different methods of processing aortic homografts. Thorax. 1969 Nov;24(6):746–749. doi: 10.1136/thx.24.6.746. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Welch W., Potvliege P., Primo G. Autologous fascia lata cardiac valve replacement. Thorax. 1971 May;26(3):271–276. doi: 10.1136/thx.26.3.271. [DOI] [PMC free article] [PubMed] [Google Scholar]

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