Comparative study of the protease digestion of No-React and conventional glutaraldehyde treated bioprosthetic heart valves

Bioprosthetic heart valves have been tanned by conventional glutaraldehyde for many years. This comparative study investigates the merit of the Biocor No-React aldehyde detoxification process as an alternative biochemical modifier of renograft tissues. An in-vitro protease digestion study was performed by measuring the weight lost of tissue samples after incubated in a designed protease solution (pH=7.40) at 37°C for 22 hours. The percentage weight lost of glutaraldehyde-treated and No-React treated bovine pericardial xenografts is 14.8±0.8 and 10.4±0.5 respectively (p<0.05), while the percentage weight lost of the fresh pericardial sample is 62.5±1.2. The percentage weight lost of a glutaraldehyde-treated and of a No-React treated cusp is 49.3±1.6 and 36.0±4.2, respectively (p<0.05). The No-React treatment on both pericardial xenografts and cusps enhances the resistance to proteolytic digestion compared to the glutaraldehyde treatment. It is concluded that the No-React treatment is superior to the glutaraldehyde treatment for the stabilization the heart valve bioprostheses. These reported studies and other in-vivo studies performed in the authors´ laboratories have confirmed that the No-React process has a clear advantage over the conventional treatment. Long term clinical experience will be the ultimate confirmation of these advantages