1
|
Mizuno T, Iwai R, Moriwaki T, Nakayama Y. Application of Biosheets as Right Ventricular Outflow Tract Repair Materials in a Rat Model. Front Vet Sci 2022; 9:837319. [PMID: 35464349 PMCID: PMC9024079 DOI: 10.3389/fvets.2022.837319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/17/2022] [Indexed: 11/16/2022] Open
Abstract
Purposes We report the experimental use of completely autologous biomaterials (Biosheets) made by “in-body tissue architecture” that could resolve problems in artificial materials and autologous pericardium. Here, Biosheets were implanted into full-thickness right ventricular outflow tract defects in a rat model. Their feasibility as a reparative material for cardiac defects was evaluated. Methods As the evaluation of mechanical properties of the biosheets, the elastic moduli of the biosheets and RVOT-free walls of rats were examined using a tensile tester. Biosheets and expanded polytetrafluoroethylene sheet were used to repair transmural defects surgically created in the right ventricular outflow tracts of adult rat hearts (n = 9, each patch group). At 4 and 12 weeks after the operation, the hearts were resected and histologically examined. Results The strength and elastic moduli of the biosheets were 421.3 ± 140.7 g and 2919 ± 728.9 kPa, respectively, which were significantly higher than those of the native RVOT-free walls (93.5 ± 26.2 g and 778.6 ± 137.7 kPa, respectively; P < 0.005 and P < 0.001, respectively). All patches were successfully implanted into the right ventricular outflow tract-free wall of rats. Dense fibrous adhesions to the sternum on the epicardial surface were also observed in 7 of 9 rats with ePTFE grafts, whereas 2 of 9 rats with biosheets. Histologically, the vascular-constructing cells were infiltrated into Biosheets. The luminal surfaces were completely endothelialized in all groups at each time point. There was also no accumulation of inflammatory cells. Conclusions Biosheets can be formed easily and have sufficient strength and good biocompatibility as a patch for right ventricular outflow tract repair in rats. Therefore, Biosheet may be a suitable material for reconstructive surgery of the right ventricular outflow tract.
Collapse
Affiliation(s)
- Takeshi Mizuno
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takeshi Mizuno
| | - Ryosuke Iwai
- Research Institute of Technology, Okayama University of Science, Okayama, Japan
| | - Takeshi Moriwaki
- Department of Mechanical Science and Engineering, Faculty of Science and Technology, Hirosaki University, Aomori, Japan
| | | |
Collapse
|
2
|
Implanted In-Body Tissue-Engineered Heart Valve Can Adapt the Histological Structure to the Environment. ASAIO J 2018. [DOI: 10.1097/mat.0000000000000769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
3
|
Mueller I, Jansen-Park SH, Neidlin M, Steinseifer U, Abel D, Autschbach R, Rossaint R, Schmitz-Rode T, Sonntag SJ. Design of a right ventricular mock circulation loop as a test bench for right ventricular assist devices. ACTA ACUST UNITED AC 2017; 62:131-137. [PMID: 27987352 DOI: 10.1515/bmt-2016-0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
Right heart failure (RHF), e.g. due to pulmonary hypertension (PH), is a serious health issue with growing occurrence and high mortality rate. Limited efficacy of medication in advanced stages of the disease constitutes the need for mechanical circulatory support of the right ventricle (RV). An essential contribution to the process of developing right ventricular assist devices (RVADs) is the in vitro test bench, which simulates the hemodynamic behavior of the native circulatory system. To model healthy and diseased arterial-pulmonary hemodynamics in adults (mild and severe PH and RHF), a right heart mock circulation loop (MCL) was developed. Incorporating an anatomically shaped silicone RV and a silicone atrium, it not only enables investigations of hemodynamic values but also suction events or the handling of minimal invasive RVADs in an anatomical test environment. Ventricular pressure-volume loops of all simulated conditions as well as pressure and volume waveforms were recorded and compared to literature data. In an exemplary test, an RVAD was connected to the apex to further test the feasibility of studying such devices with the developed MCL. In conclusion, the hemodynamic behavior of the native system was well reproduced by the developed MCL, which is a useful basis for future RVAD tests.
Collapse
Affiliation(s)
- Indra Mueller
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Pauwelsstr.20, 52074 Aachen
| | - So-Hyun Jansen-Park
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen
| | - Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen
| | - Dirk Abel
- Institute of Automatic Control, RWTH Aachen University, 52074 Aachen
| | - Rüdiger Autschbach
- Department of Cardiothoracic and Vascular Surgery, University Hospital RWTH Aachen, 52074 Aachen
| | - Rolf Rossaint
- Department of Anesthesiology, University Hospital RWTH Aachen, 52074 Aachen
| | - Thomas Schmitz-Rode
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen
| | - Simon Johannes Sonntag
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen
| |
Collapse
|
4
|
Fioretta ES, Dijkman PE, Emmert MY, Hoerstrup SP. The future of heart valve replacement: recent developments and translational challenges for heart valve tissue engineering. J Tissue Eng Regen Med 2017; 12:e323-e335. [PMID: 27696730 DOI: 10.1002/term.2326] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/25/2016] [Accepted: 09/26/2016] [Indexed: 12/18/2022]
Abstract
Heart valve replacement is often the only solution for patients suffering from valvular heart disease. However, currently available valve replacements require either life-long anticoagulation or are associated with valve degeneration and calcification. Moreover, they are suboptimal for young patients, because they do not adapt to the somatic growth. Tissue-engineering has been proposed as a promising approach to fulfil the urgent need for heart valve replacements with regenerative and growth capacity. This review will start with an overview on the currently available valve substitutes and the techniques for heart valve replacement. The main focus will be on the evolution of and different approaches for heart valve tissue engineering, namely the in vitro, in vivo and in situ approaches. More specifically, several heart valve tissue-engineering studies will be discussed with regard to their shortcomings or successes and their possible suitability for novel minimally invasive implantation techniques. As in situ heart valve tissue engineering based on cell-free functionalized starter materials is considered to be a promising approach for clinical translation, this review will also analyse the techniques used to tune the inflammatory response and cell recruitment upon implantation in order to stir a favourable outcome: controlling the blood-material interface, regulating the cytokine release, and influencing cell adhesion and differentiation. In the last section, the authors provide their opinion about the future developments and the challenges towards clinical translation and adaptation of heart valve tissue engineering for valve replacement. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Emanuela S Fioretta
- Institute for Regenerative Medicine (IREM), University of Zurich, Switzerland
| | - Petra E Dijkman
- Institute for Regenerative Medicine (IREM), University of Zurich, Switzerland
| | - Maximilian Y Emmert
- Institute for Regenerative Medicine (IREM), University of Zurich, Switzerland.,Heart Center Zurich, University Hospital Zurich, Switzerland.,Wyss Translational Center Zurich, Switzerland
| | - Simon P Hoerstrup
- Institute for Regenerative Medicine (IREM), University of Zurich, Switzerland.,Wyss Translational Center Zurich, Switzerland.,Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| |
Collapse
|
5
|
Dijkman PE, Fioretta ES, Frese L, Pasqualini FS, Hoerstrup SP. Heart Valve Replacements with Regenerative Capacity. Transfus Med Hemother 2016; 43:282-290. [PMID: 27721704 DOI: 10.1159/000448181] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/04/2016] [Indexed: 01/14/2023] Open
Abstract
The incidence of severe valvular dysfunctions (e.g., stenosis and insufficiency) is increasing, leading to over 300,000 valves implanted worldwide yearly. Clinically used heart valve replacements lack the capacity to grow, inherently requiring repetitive and high-risk surgical interventions during childhood. The aim of this review is to present how different tissue engineering strategies can overcome these limitations, providing innovative valve replacements that proved to be able to integrate and remodel in pre-clinical experiments and to have promising results in clinical studies. Upon description of the different types of heart valve tissue engineering (e.g., in vitro, in situ, in vivo, and the pre-seeding approach) we focus on the clinical translation of this technology. In particular, we will deepen the many technical, clinical, and regulatory aspects that need to be solved to endure the clinical adaptation and the commercialization of these promising regenerative valves.
Collapse
Affiliation(s)
- Petra E Dijkman
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Emanuela S Fioretta
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Laura Frese
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | | | - Simon P Hoerstrup
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands; Wyss Translational Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Sumikura H, Nakayama Y, Ohnuma K, Takewa Y, Tatsumi E. Development of a stent-biovalve with round-shaped leaflets: in vitro hydrodynamic evaluation for transcatheter pulmonary valve implantation (TPVI). J Artif Organs 2016; 19:357-363. [PMID: 27230085 DOI: 10.1007/s10047-016-0909-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
This study evaluates a newly designed autologous heart valve-shaped tissue with a stent [stent-biovalve (SBV)] for transcatheter pulmonary valve implantation using the "in-body tissue architecture" technology. In the previously developed SBV with flat-shaped leaflets (FS-SBV), the valve could not close rapidly, because the leaflets were fixed in the open position, which induced regurgitant volume in the closing phase. Therefore, a novel mold to fabricate an SBV with round-shaped leaflets (RS-SBV) was developed, and its hydrodynamic performance with different valve diameters was evaluated in this study. A specially designed, self-expandable, stent-mounted, acrylic mold, which has 3 hemispheres, was placed in dorsal subcutaneous pouches of goats for 2 months. After extraction, the acrylic mold was removed from the implant, and a tubular tissue impregnated with the stent strut was obtained. Half of the tubular tissue with 3 hemispheres was completely folded in half inwards. The acrylic mold was designed, such that the folded half of the tubular tissue became the round-shaped leaflets. The 3 commissure parts were connected to form 3 leaflets, resulting in the preparation of the RS-SBV (internal diameter 25 mm). The RS-SBV closed more rapidly than the FS-SBV in a pulsatile mock circulation circuit under the pulmonary circulation conditions. The regurgitant fraction of the RS-SBV was approximately 6 %, which was lower than that of the FS-SBV. The appropriate pulmonary annulus diameter of the RS-SBV was from 24 to 25 mm based on the pressure difference and effective orifice area.
Collapse
Affiliation(s)
- Hirohito Sumikura
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita-Shi, Osaka, 565-8565, Japan.
| | - Yasuhide Nakayama
- Division of Medical Engineering and Materials, National Cerebral and Cardiovascular Center Research Institute, Suita-Shi, Japan
| | - Kentaro Ohnuma
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita-Shi, Osaka, 565-8565, Japan
| | - Yoshiaki Takewa
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita-Shi, Osaka, 565-8565, Japan
| | - Eisuke Tatsumi
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita-Shi, Osaka, 565-8565, Japan
| |
Collapse
|
7
|
Sawa Y, Matsuda K, Tatsumi E, Matsumiya G, Tsukiya T, Abe T, Fukunaga K, Kishida A, Kokubo K, Masuzawa T, Myoui A, Nishimura M, Nishimura T, Nishinaka T, Okamoto E, Tokunaga S, Tomo T, Yagi Y, Yamaoka T. Journal of Artificial Organs 2015: the year in review : Journal of Artificial Organs Editorial Committee. J Artif Organs 2016; 19:1-7. [PMID: 26896942 DOI: 10.1007/s10047-016-0886-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Y Sawa
- Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - K Matsuda
- Emergency and Critical Care Medicine, University of Yamanashi Hospital, Yamanashi, Japan
| | - E Tatsumi
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - G Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - T Tsukiya
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - T Abe
- Department of Urology, Iwate Medical University School of Medicine, Iwate, Japan
| | - K Fukunaga
- Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - A Kishida
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Kokubo
- Department of Medical Engineering and Technology, Kitasato University School of Allied Health Science, Kanagawa, Japan
| | - T Masuzawa
- Department of Mechanical Engineering, Ibaraki University, Ibaraki, Japan
| | - A Myoui
- Medical Center for Translational Research, Osaka University Hospital, Osaka, Japan
| | - M Nishimura
- Division of Organ Regeneration Surgery, Tottori University Faculty of Medicine, Tottori, Japan
| | - T Nishimura
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - T Nishinaka
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - E Okamoto
- Department of Human Science and Informatics, School of Bioscience and Engineering, Tokai University, Sapporo, Japan
| | - S Tokunaga
- The Department of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - T Tomo
- Second Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Y Yagi
- Department of Clinical Engineering, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Yamaoka
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| |
Collapse
|
8
|
Nakayama Y, Furukoshi M. Feasibility of In-body Tissue Architecture (IBTA) in Pediatric Cardiovascular Surgery: Development of Regenerative Autologous Tissues with Growth Potential. ACTA ACUST UNITED AC 2016. [DOI: 10.9794/jspccs.32.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yasuhide Nakayama
- Division of Medical Engineering and Materials,
National Cerebral and Cardiovascular Center Research Institute
| | - Maya Furukoshi
- Division of Medical Engineering and Materials,
National Cerebral and Cardiovascular Center Research Institute
| |
Collapse
|