In vivo behavior of epoxy-crosslinked porcine heart valve cusps and walls

Pauline B. van Wachem, Linda A. Brouwer, R. Zeeman, Pieter J. Dijkstra, Jan Feijen, Marc Hendriks, Patrick T. Cahalan, Marja J.A. van Luyn

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Calcification limits the long-term durability of xenograft glutaraldehyde-crosslinked heart valves. In this study, epoxy-crosslinked porcine aortic valve tissue was evaluated after subcutaneous implantation in weanling rats. Non-crosslinked valves and valves crosslinked with glutaraldehyde or carbodiimide functioned as control. Epoxy-crosslinked valves had somewhat lower shrinkage temperatures than the crosslinked controls, and within the series also some macroscopic and microscopic differences were obvious. After 8 weeks implantation, cusps from non-crosslinked valves were not retrieved. The matching walls were more degraded than the epoxy- and control-crosslinked walls. This was observed from the higher cellular ingrowth with fibroblasts, macrophages, and giant cells. Furthermore, non-crosslinked walls showed highest numbers of lymphocytes, which were most obvious in the capsules. Epoxy- and control-crosslinked cusps and walls induced lower reactions. Calcification, measured by von Kossa-staining and by Ca-analysis, was always observed. Crosslinked cusps calcified more than walls. Of all wall samples, the non-crosslinked walls showed the highest calcification. It is concluded that epoxy-crosslinked valve tissue induced a foreign body and calcification reaction similar to the two crosslinked controls. Therefore, epoxy-crosslinking does not represent a solution for the calcification problem of heart valve bioprostheses.
Original languageUndefined
Pages (from-to)18-27
JournalJournal of biomedical materials research
Issue number1
Publication statusPublished - 2000


  • METIS-106561
  • Cross-linking
  • Calcification
  • IR-71568
  • heart valve
  • epoxy
  • Prosthesis

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