Abstract

The aim of our experimental work was to assess the impact and morphological changes that arise during different thawing protocols on human aortic valve (AV) leaflets resected from cryopreserved aortic root allografts (CARAs). Two thawing protocols were tested: 1. CARAs were thawed at a room temperature (23°C); 2. CARAs were placed directly into a water bath at a temperature of 37°C. After all the samples were thawed, non-coronary AV leaflets were sampled from each specimen and fixed in a 4% formaldehyde solution before they were sent for morphological analysis. All the samples were washed in distilled water for 5 min and dehydrated in a graded ethanol series (70%, 85%, 95%, and 100%) for 5 min at each level. The tissue samples were then immersed in 100% hexamethyldisilazane (HMDS) for 10 min, and then air-dried in an exhaust hood at room temperature. Processed samples were mounted on stainless steel stubs and coated with gold. Histological analysis was performed with the use of an electron microscope on a scanning mode operating at 25 kV - BS 301. Thawing protocol 1 (room temperature at 23°C): 6 (100%) samples showed loss of the endothelial covering of the basal membrane with no damage to the basal lamina. Thawing protocol 2 (water bath at 37°C): 5 (83%) samples showed loss of the endothelial covering of the basal membrane with no damage to the basal lamina. One (17%) sample showed loss of the endothelial covering the basal membrane with significant damage to the basal membrane. Based on our experimental work, we can clearly conclude that cryopreserved AV leaflet allografts show identical structural changes at different rates of thawing.

Highlights

  • The first allograft transplants in cardiac surgery were freshly harvested aortic valves (AVs)

  • The aim of our experimental work was to assess the impact and morphological changes that arise during different thawing protocols on human aortic valve (AV) leaflets resected from cryopreserved aortic root allografts (CARAs)

  • Histological analysis of the ARA arterial wall was as follows: ––thawing protocol 1: 6 (100%) non-coronary AV leaflets showed loss of the endothelial cells covering the basal membrane with no damage to the basal lamina (Fig. 1); ––thawing protocol 2: 5 (83%) noncoronary AV leaflets showed loss of the endothelial cells covering the basal membrane with no damage to the basal lamina; 1 (17%) non-coronary AV leaflet showed significant damage to the basal membrane (Fig. 2)

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Summary

Introduction

The first allograft transplants in cardiac surgery were freshly harvested aortic valves (AVs). The first fresh AV allograft transplant was performed by Murray in 1956.1 Despite the imperfect hemodynamic outcome of the operation, the allograft performance was outstanding, with perfect leaflet function. Other early experimental and clinical trials, such as Heimbecker, Lam et al and Kerwin et al, supported the superior properties of fresh AV allografts.[2,3,4] the first successful operation with a patient surviving the fresh AV allograft transplant was performed by Ross in 1962, based on Brewin’s experimental work.[5,6]. The aim of our experimental work was to assess the impact and morphological changes that arise during different thawing protocols on human aortic valve (AV) leaflets resected from cryopreserved aortic root allografts (CARAs)

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