Rapid anticalcification treatment for glutaraldehyde-fixed autologous tissue in cardiovascular surgery

In Situ Cross-Linked Collagen-Based Biological Patch Integrating Anti-Infection and Anti-Calcification Properties

Acellular dermal matrix (ADM) can be used as collagen-based biological patches for regeneration and repair of soft tissues in vivo. However, the problems of calcification and infection during treatment with patches can lead to premature patch failure and even to a severely increased risk of recurrence. In this study, first, porcine ADM (pADM) grafted with vinyl underwent an in situ cross-linking reaction in the presence of an initiator, while quaternary ammonium groups were introduced into the pADM during the cross-linking process to obtain MA-DMC-pADM, which is a biological patch with anti-infection and anti-calcification properties. The results of physicochemical property tests of the material showed that the pADM after cross-linking had better physical and mechanical properties. Importantly, antibacterial and anti-calcification experiments showed that MA-DMC-pADM had a good antibacterial and anti-calcification effect. Therefore, the MA-DMC-pADM biological patch facilitates their longer-lasting effectiveness, allowing pADM to be used in a wider range of applications.

Inhibition of advanced glycation end product formation and serum protein infiltration in bioprosthetic heart valve leaflets: Investigations of anti-glycation agents and anticalcification interactions with ethanol pretreatment

Bioprosthetic heart valves (BHV) fabricated from heterograft tissue, such as glutaraldehyde pretreated bovine pericardium (BP), are the most frequently used heart valve replacements. BHV durability is limited by structural valve degeneration (SVD), mechanistically associated with calcification, advanced glycation end products (AGE), and serum protein infiltration. We investigated the hypothesis that anti-AGE agents, Aminoguanidine, Pyridoxamine [PYR], and N-Acetylcysteine could mitigate AGE-serum protein SVD mechanisms in vitro and in vivo, and that these agents could mitigate calcification or demonstrate anti-calcification interactions with BP pretreatment with ethanol. In vitro, each of these agents significantly inhibited AGE-serum protein infiltration in BP. However, in 28-day rat subdermal BP implants only orally administered PYR demonstrated significant inhibition of AGE and serum protein uptake. Furthermore, BP PYR preincubation of BP mitigated AGE-serum protein SVD mechanisms in vitro, and demonstrated mitigation of both AGE-serum protein uptake and reduced calcification in vivo in 28-day rat subdermal BP explants. Inhibition of BP calcification as well as inhibition of AGE-serum protein infiltration was observed in 28-day rat subdermal BP explants pretreated with ethanol followed by PYR preincubation. In conclusion, AGE-serum protein and calcification SVD pathophysiology are significantly mitigated by both PYR oral therapy and PYR and ethanol pretreatment of BP.