Substituição do tronco da artéria pulmonar em carneiros, utilizando heteroenxerto tubular valvado, preservado em L-HydroR
Arquivos
Data
2011
Autores
Souza, Helmgton José Brito de 
Orientadores
Buffolo, Enio
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: As biopróteses valvares cardíacas estão relacionadas a
eventos tromboembólicos, infecciosos e degenerativos. Seu desgaste é
atribuído principalmente à desnaturação do colágeno. O glutaraldeído,
método predominante de preservação de biopróteses, favorece o processo
de calcificação e limita sua durabilidade. Diversas técnicas tentam conter o
processo degenerativo das biopróteses. Objetivos: Avaliar o processo de
calcificação, in vivo, de heteroenxertos pulmonares valvados, preservados
em meios não aldeídico (L-HydroR). Métodos: 17 carneiros foram
submetidos à substituição do tronco da artéria pulmonar por enxerto tubular
valvado de pericárdio bovino. Os animais foram distribuídos em dois
grupos: Grupo L-HydroR (teste / n=14) e Grupo Glutaraldeído (controle /
n=3). Cerca de 150 dias pós implante, foram realizadas angiografia,
medidas hemodinâmicas e sacrifício. Os animais foram necropsiados e as
próteses submetidas a estudo anátomo-patológico, avaliação radiológica e
dosagem do cálcio por espectofotometria de absorção atômica. A análise
estatística foi obtida através dos testes exato de Fisher, T de Student ou
Mann-Whitney (significância: 5%). Resultados: O desempenho
hemodinâmico e angiográfico das próteses testadas foi semelhante nos dois
grupos. A avaliação radiológica, a macroscopia, a microscopia e a dosagem
de cálcio por espectrofotometria de absorção atômica mostraram maior
calcificação nas próteses do Grupo Glutaraldeído, quando comparadas às
próteses do Grupo L-HydroR (p=0,001). 07 animais do Grupo L-HydroR
(50%) apresentaram aderência das cúspides à parede do tubo (p=0,228).
Conclusões: As próteses preservadas em L-HydroR mostraram-se mais
resistentes à calcificação, quando comparadas às preservadas em
Glutaraldeído.
Introduction: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses. Objectives: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-HydroR). Methods: 17 sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-HydroR (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation, angiography was performed, hemodynamic measurements and sacrifice. The mice were sacrificed and the prostheses subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%). Results: The angiographic and hemodynamic performance of prostheses tested was similar in both groups. Radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthesis Glutaraldehyde Group, when compared to L-HydroR Group prosthesis (p =0.001). 07 animals in Group L-HydroR (50%) had adherence of the leaflets to the wall of the tube (p = 0.228). Conclusions: Prostheses preserved in LHydroR were more resistant to calcification when compared with Glutaraldehyde preserved.
Introduction: The cardiac bioprostheses are related to thromboembolic events, infectious and degenerative diseases. Wear is mainly attributed to the denaturation of collagen. Glutaraldehyde, the predominant method of preservation of bioprostheses, favors the calcification process and limits their durability. Several techniques try to contain the degenerative process of bioprostheses. Objectives: To evaluate the process of calcification in vivo pulmonary valve heterografts preserved in non-aldehydic (L-HydroR). Methods: 17 sheep underwent replacement of the pulmonary artery valved tubular grafts of bovine pericardium. The animals were divided into two groups: Group L-HydroR (test / n = 14) and Group Glutaraldehyde (control / n = 3). About 150 days after implantation, angiography was performed, hemodynamic measurements and sacrifice. The mice were sacrificed and the prostheses subjected to a pathological study, radiological evaluation and measurement of calcium by atomic absorption spectrophotometry. Statistical analysis was obtained through the Fisher's exact test, Student's t or Mann-Whitney test (significance: 5%). Results: The angiographic and hemodynamic performance of prostheses tested was similar in both groups. Radiological evaluation, the macroscopic and microscopic measurement of serum calcium by atomic absorption spectrophotometry showed increased calcification of the prosthesis Glutaraldehyde Group, when compared to L-HydroR Group prosthesis (p =0.001). 07 animals in Group L-HydroR (50%) had adherence of the leaflets to the wall of the tube (p = 0.228). Conclusions: Prostheses preserved in LHydroR were more resistant to calcification when compared with Glutaraldehyde preserved.
Descrição
Citação
SOUZA, Helmgton José Brito de. Substituição do tronco da artéria pulmonar em carneiros, utilizando heteroenxerto tubular valvado, preservado em L-HydroR. 2011.136 f. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2011.