Mechanical Stress: An Independent Determinant of Early Bioprosthetic Calcification in Humans

Kenneth K. Liao, Xiaohuan Li, Ranjit John, Devesh M. Amatya, Lyle D. Joyce, Soon J. Park, Richard Bianco, R. Morton Bolman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)491-495
Number of pages5
JournalAnnals of Thoracic Surgery
Volume86
Issue number2
DOIs
StatePublished - Aug 2008

Fingerprint

Mechanical Stress
Heart-Assist Devices
Linear Models
X-Ray Film
Swine
X-Rays
Calcium
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Liao, K. K., Li, X., John, R., Amatya, D. M., Joyce, L. D., Park, S. J., ... Bolman, R. M. (2008). Mechanical Stress: An Independent Determinant of Early Bioprosthetic Calcification in Humans. Annals of Thoracic Surgery, 86(2), 491-495. https://doi.org/10.1016/j.athoracsur.2008.03.061

Mechanical Stress : An Independent Determinant of Early Bioprosthetic Calcification in Humans. / Liao, Kenneth K.; Li, Xiaohuan; John, Ranjit; Amatya, Devesh M.; Joyce, Lyle D.; Park, Soon J.; Bianco, Richard; Bolman, R. Morton.

In: Annals of Thoracic Surgery, Vol. 86, No. 2, 08.2008, p. 491-495.

Research output: Contribution to journalArticle

Liao, KK, Li, X, John, R, Amatya, DM, Joyce, LD, Park, SJ, Bianco, R & Bolman, RM 2008, 'Mechanical Stress: An Independent Determinant of Early Bioprosthetic Calcification in Humans', Annals of Thoracic Surgery, vol. 86, no. 2, pp. 491-495. https://doi.org/10.1016/j.athoracsur.2008.03.061
Liao, Kenneth K. ; Li, Xiaohuan ; John, Ranjit ; Amatya, Devesh M. ; Joyce, Lyle D. ; Park, Soon J. ; Bianco, Richard ; Bolman, R. Morton. / Mechanical Stress : An Independent Determinant of Early Bioprosthetic Calcification in Humans. In: Annals of Thoracic Surgery. 2008 ; Vol. 86, No. 2. pp. 491-495.
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AU - Park, Soon J.

AU - Bianco, Richard

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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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