Morphological Study on Glutaraldehyde-treated Porcine Valvular Bioprostheses Used as Substitute Cardiac Valves

The anatomy of the normal porcine aortic valve and the pathologic changes that develop in glutaraldehyde-treated porcine valvular bioprostheses used as substitute cardiac valve in patients are presented. The significant changes following implantation are: 1) thrombosis, which composed of fibrin, platelets and red cells, 2) intracuspal hematoma, which is localized in the spongiosa, extended from the basal region towards the free edge of the cusps, and formed a place of dissection which involved the spaces left in the spongiosa by the removal of proteoglycan material during preimplantation commercial processing, 3) infection, which bacteria develop in the fibrin layer that covers the cusps, and can involve in the spongiosa, 4) breakdown of collagen fibers, which occurs mainly as a consequence of mechanical factors (materials fatigue) related to the bending of the fibrils, and leads to perforation of the cusps, 5) endothelization, which is located on thrombus and fibrous sheath composed of type III collagen fibrils, elastic fibers, myofibrocyte-like cells and macrophages, 6) calcification, which occurs into main sites