A precise radiographic technique for the measurement of dimensional changes in heart valve biomaterials following fixation

Accurate tissue thickness measurements are difficult to acquire by present techniques. Error is introduced by tissue compression during measurements or by tissue processing prior to measurement. In the field of valve replacement, tissue dimensional changes from fixation prior to implantation may predispose implants to premature tissue failure and it becomes important to have an accurate method for comparing cusp dimensions pre- and post-fixation. A new approach is to use high-resolution digital radiography to make thickness maps of entire specimens. For 25 matched porcine aortic valve cusps, we have evaluated this techniqueʹs ability to measure and compare thickness, surface area and volume before and after 7 days of aldehyde fixation. Digital radiographs were acquired pre- and post-0.5% glutaraldehyde (n=13) or 10% formaldehyde (n=12) fixation. Mean thickness, surface area, volume and four measurements to evaluate shape differences with fixation were obtained and compared pre- and post-fixation using paired t tests. The results demonstrate that this X-ray imaging technique can provide dimensions of matched fresh and fixed specimens and is sensitive enough to show statistically significant changes due to fixation. These findings also illustrate that aldehyde fixation can cause tissue contraction resulting in a significant overall increase in tissue thickness and a decrease in surface area. This technique could be used to gain further insights into tissue anatomy and mechanics.