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J Thorac Cardiovasc Surg 1996;111:218-230
© 1996 Mosby, Inc.
SURGERY FOR ACQUIRED HEART DISEASE |
Antwerp, Belgium
Received for publication Nov. 21, 1994. Accepted for publication Feb. 22, 1995. Address for reprints: Xiao J. Feng, MD, Department of Pharmacology, University of Antwerp (UIA), Universiteitsplein 1, B-2610 Wilrijk, Belgium.
Abstract
Endothelial integrity and function may be an important determinant for long-term success of allograft heart valves. To determine the optimal storage temperatures for preservation of long-term endothelial function in porcine aortic valves, different storage temperatures and times were investigated. Fresh valves were either (1) stored at 4° C, with or without 10% fetal calf serum supplement, for 1, 2, 4, 7, 14, 21, or 28 days; (2) cryopreserved for 2, 4, or 8 weeks at -80º C or -170° C; (3) cryopreserved in long-term storage (as long as 1 year), with or without fetal calf serum, at -170° C. Viability of endothelial cells was assessed through measurement of the production of prostacyclin in basal and bradykinin-stimulated conditions, during in vitro incubation of the valve cusps at 37° C. Endothelial morphologic variations in valves stored at 4° C were evaluated by scanning electron microscopy. With storage at 4° C, after 4 days the valves already produced significantly less (p < 0.05) prostacyclin than fresh preparations in both basal (0.21 ± 0.04 versus 3.56 ± 0.03 ng · ml-1 · cm-2) and stimulated conditions (4.17 ± 0.36 vs 24.23 ± 1.83). Morphologic changes could not yet be distinguished with scanning electron microscopy at that time. When the storage period was extended, the levels of prostacyclin further diminished; after 14 days, prostacyclin release could no longer be detected. In cryopreserved valves, prostacyclin production was similar for as long as 2 weeks of storage either at -80° C or at -170° C in basal (2.69 ± 0.63 vs 2.93 ± 0.51) and stimulated (16.43 ± 3.19 vs 16.50 ± 2.57, = 6) conditions. After 8 weeks, no prostacyclin release could be detected in valves stored at -80° C. After 6 months storage at -170° C, the prostacyclin production was significantly (p < 0.05) reduced compared with fresh valves; it then remained constant for as long as 1 year. The valves stored with fetal calf serum produced significantly (p < 0.05) less prostacyclin than did those without fetal calf serum. For longer cryopreserved banking, we recommend storing heart valves at -170° C instead of at -80° C to maintain viability of endothelial cells. Fetal calf serum would harm endothelial viability during long-term cryopreservation. (J THORAC CARDIOVASC SURG 1996;111:218-30)
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