Abstract
The first 2–3 decades of artificial valve technology were filled with basic studies involving function, design, hemodynamics, and performance. Since that time, most investigations and industry innovations have dealt with relatively minor changes (improvements?) in less important details driven more by marketing and competition than by real scientific curiosity. Duarte and colleagues have undertaken a much more basic investigation into preparation of bioprosthetic valves and have shown some striking changes in different methodologies starting from the reasonable premise that calcification in bioprosthetic leaflets is one important cause, not only of decreased longevity but, of impaired function, as well. The striking difference in the amounts of calcium in leaflet tissue in valves treated with the α-amino oleic acid (AOA) process compared with the other two groups is impressive—9.6 μgCa/mg tissue versus 96.3 μg and 130 μg in groups 2 and 3, respectively. This also translates into a significant increase in survival in the animals with AOA valve implants. Additionally, even the orifice area (obviously a function of sustained leaflet mobility) was significantly larger at the time of explant in the AOA group compared with the non–AOA group.
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