Rapid versus slow degeneration and complications of biomaterials in patients with congenital heart disease

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology Pub Date : 2024-12-31 DOI:10.1016/j.carpath.2024.107712

Armin Darius Peivandi , Michael Holtkamp , Hennes Rave , Lars Linsen , Sven Martens , Klaus-Michael Müller , Uwe Karst , Sabrina Martens

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引用次数: 0

Abstract

Objectives

Re-operations due to material degeneration carry a burden for patients with congenital heart disease (CHD). The study aim was to compare rapid vs. slow degeneration of biomaterials in CHD patients.

Methods

Explants from re-operations of 29 CHD patients (2015-2022) were grouped according to the duration of implantation (short implantation < 3 years (n = 16) vs. long implantation 10-15 years (n = 13)). Histologic processing and staining allowed tissue and calcification analysis. Micro-X-ray fluorescence (µXRF) was used for elemental analysis. Semi-quantitative comparison of calcium was conducted using a self-developed software.

Results

Thrombosis was recurrently observed in short-implanted RVOT samples. 62.5 % (n = 10) of short-implanted samples showed calcification in Alizarin red staining, in comparison to 69.2 % (n = 9) in the long-implanted group. µXRF analysis revealed calcium deposits in all patients, mostly co-localized with phosphorus. In the short implant group, other detected elements included iron, chlorine, chromium, nickel, titanium and zinc. In the long implant group, iron, nickel, titanium, zinc, copper and iodine were found. No significant difference in calcification (Ca-Si-ratio) between both implantation groups (p = 0.083) was found.

Conclusion

Thrombus formation is a main rapid degeneration cause in the RVOT. Deteriorations of biomaterials in CHD patients show strong parallels to bioprosthetic valve degenerations. Early calcification in young patients is supported by our semi-quantitative calcium analysis. The role of other elements in graft degeneration remains to be assessed in the future.

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先天性心脏病患者生物材料的快速与缓慢变性及并发症

目的：先天性心脏病（CHD）患者因材料变性而再次手术的负担很重。研究旨在比较先天性心脏病（CHD）患者生物材料的快速退化与缓慢退化：29例CHD患者（2015-2022年）再次手术的切片根据植入时间分组（短期植入<3年（16例）与长期植入10-15年（13例））。通过组织学处理和染色，可以对组织和钙化进行分析。微X射线荧光（µXRF）用于元素分析。使用自行开发的软件对钙进行半定量比较：结果：在短时间内植入的 RVOT 样品中反复观察到血栓形成。在茜素红染色中，62.5%（n=10）的短植入样本出现钙化，相比之下，长植入组的钙化率为 69.2%（n=9）。µXRF分析显示，所有患者都有钙沉积，大部分与磷共定位。在短种植体组中，检测到的其他元素包括铁、氯、铬、镍、钛和锌。在长种植体组中，发现了铁、镍、钛、锌、铜和碘。两组植入物在钙化（钙硅比）方面无明显差异（P=0.083）：结论：血栓形成是 RVOT 快速退化的主要原因。结论：血栓形成是 RVOT 快速退化的主要原因，心脏病患者的生物材料退化与生物人工瓣膜退化有很大相似之处。我们的半定量钙分析支持年轻患者的早期钙化。其他因素在移植物退化中的作用仍有待今后评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Pathology 医学-病理学

CiteScore

7.50

自引率

2.70%

发文量

审稿时长

18 days

期刊介绍： Cardiovascular Pathology is a bimonthly journal that presents articles on topics covering the entire spectrum of cardiovascular disease. The Journal''s primary objective is to publish papers on disease-oriented morphology and pathogenesis from clinicians and scientists in the cardiovascular field. Subjects covered include cardiovascular biology, prosthetic devices, molecular biology and experimental models of cardiovascular disease.