TY - JOUR
T1 - Mechanical Stress
T2 - An Independent Determinant of Early Bioprosthetic Calcification in Humans
AU - Liao, Kenneth K.
AU - Li, Xiaohuan
AU - John, Ranjit
AU - Amatya, Devesh M.
AU - Joyce, Lyle D.
AU - Park, Soon J.
AU - Bianco, Richard
AU - Bolman, R. Morton
PY - 2008/8
Y1 - 2008/8
N2 - Background: Mechanical stress is one of the contributing factors for bioprosthetic calcification. A HeartMate XVE (Thoratec, CA) left ventricular assist device (LVAD) has two identical porcine valves, one for inflow and the other for outflow. The inflow valve endures a higher closing pressure than the outflow valve; thus, an implanted LVAD offers an ideal human model to study the independent effect of stress on calcification. Methods: Sixty-four pairs of LVAD inflow and outflow valves underwent gross examination, histologic study, and x-ray imaging. X-ray films were converted to digital images, and the calcification area was calculated. The distribution of calcium deposits was documented. The frequency and degree of calcification in both valves were analyzed (paired t test). Calcification of both valves in relationship to the duration of LVAD implantation and to the patient's age was also analyzed (linear regression). Results: The mean age of patients supported with LVAD was 55 ± 12 years (range, 17 to 77 years). The mean duration of LVAD implantation was 265 ± 151 days (range, 3 to 630 days). Calcification developed more commonly in inflow valves. The calcification area (CA) was larger in the inflow valves (21.6 ± 30.7 mm2) than in the outflow valves (15.1 ± 26.2 mm2, p < 0.05). There was a positive relationship between CA and days of implantation for both valves (inflow CA = 4.96 ± 0.063 days; outflow, CA = 2.39 ± 0.047 days, linear regression; p < 0.05 for both). Conclusions: Mechanical stress is an independent determinant of early bioprosthetic calcification in humans.
AB - Background: Mechanical stress is one of the contributing factors for bioprosthetic calcification. A HeartMate XVE (Thoratec, CA) left ventricular assist device (LVAD) has two identical porcine valves, one for inflow and the other for outflow. The inflow valve endures a higher closing pressure than the outflow valve; thus, an implanted LVAD offers an ideal human model to study the independent effect of stress on calcification. Methods: Sixty-four pairs of LVAD inflow and outflow valves underwent gross examination, histologic study, and x-ray imaging. X-ray films were converted to digital images, and the calcification area was calculated. The distribution of calcium deposits was documented. The frequency and degree of calcification in both valves were analyzed (paired t test). Calcification of both valves in relationship to the duration of LVAD implantation and to the patient's age was also analyzed (linear regression). Results: The mean age of patients supported with LVAD was 55 ± 12 years (range, 17 to 77 years). The mean duration of LVAD implantation was 265 ± 151 days (range, 3 to 630 days). Calcification developed more commonly in inflow valves. The calcification area (CA) was larger in the inflow valves (21.6 ± 30.7 mm2) than in the outflow valves (15.1 ± 26.2 mm2, p < 0.05). There was a positive relationship between CA and days of implantation for both valves (inflow CA = 4.96 ± 0.063 days; outflow, CA = 2.39 ± 0.047 days, linear regression; p < 0.05 for both). Conclusions: Mechanical stress is an independent determinant of early bioprosthetic calcification in humans.
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U2 - 10.1016/j.athoracsur.2008.03.061
DO - 10.1016/j.athoracsur.2008.03.061
M3 - Article
C2 - 18640322
AN - SCOPUS:47149107463
SN - 0003-4975
VL - 86
SP - 491
EP - 495
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 2
ER -