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International Journal of Biomaterials
Volume 2013, Article ID 617329, 7 pages
Research Article

Evolving Bioprosthetic Tissue Calcification Can Be Quantified Using Serial Multislice CT Scanning

1Department of Cardiovascular Diseases, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
2Department of Radiology, Katholieke Universiteit Leuven, 3000 Leuven, Belgium

Received 4 June 2013; Accepted 9 August 2013

Academic Editor: Sean Peel

Copyright © 2013 B. Meuris et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. We investigated the value of serial multislice CT scanning for in vivo determination of evolving tissue calcification in three separate experimental settings. Materials and Methods. Bioprosthetic valve tissue was implanted in three different conditions: (1) glutaraldehyde-fixed porcine stentless conduits in pulmonary position ( ); (2) glutaraldehyde-fixed stented pericardial valves in mitral position ( ); and (3) glutaraldehyde-fixed pericardial tissue as patch in the jugular vein and carotid artery ( ). Multislice CT scanning was performed at various time intervals. Results. In stentless conduits, the distribution of wall calcification can be reliably quantified with CT. After 20 weeks, the CT-determined mean calcium volume was 1831 ± 581 mm³, with a mean wall calcium content of 89.8 ± 44.4 μg/mg ( ). In stented pericardial valves implanted in mitral position, reliable determination of tissue mineralization is disturbed by scattering caused by the (continuously moving) alloy of the stent material. Pericardial patches in the neck vessels revealed progressive mineralization, with a significant increase in mean HU and calcium volume at 8 weeks after implantation, rising up to a level of 131.1 ± 39.6 mm³ (mean calcium volume score) and a mean calcium content of 19.1 ± 12.3 μg/mg. Conclusion. The process of bioprosthetic tissue mineralization can be visualized and quantified in vivo using multislice CT scanning. This allows determination of the kinetics of tissue mineralization with intermediate in vivo evaluations.