Bart Meuris1, Shigeyuki Ozaki2, William Neethling3, Stephanie De Vleeschauwer4, Eric Verbeken4, David Rhodes5, Peter Verbrugghe4, Geoff Strange6. 1. Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium. Electronic address: bart.meuris@uzleuven.be. 2. Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan. 3. Department of Cardiothoracic Surgery, University of Western Australia, Fremantle, Australia. 4. Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium. 5. Department of Materials and Science Engineering, Monash University, Melbourne, Australia. 6. Faculty of Medicine, University of Notre Dame, Fremantle, Australia.
Abstract
BACKGROUND: The purpose of this study was to provide a preliminary assessment of the performance of a decellularized pericardial patch in a trileaflet aortic valve reconstruction in a long-term juvenile sheep model. METHODS: A sheep surgical model was used to perform a complete trileaflet reconstruction (Ozaki technique) of the aortic valve with 3 separate pericardial patches. Valve function was assessed 1 week, 3 months, and 6 months after surgery via transthoracic echocardiography. Calcification resistance and host cell infiltration of the pericardial material were assessed at 6 months after surgery. RESULTS: Three of 6 sheep with implanted pericardial neo-cusps survived until the planned time of sacrifice after surgery, whereas 3 animals had a successful implant but died shortly after the procedure as the result of a bad recovery from cardiopulmonary bypass. Echocardiography at 6 months revealed a high coaptation area with only minimal regurgitation. In all explanted leaflets, cusp tissue was soft. There was only minimal calcification in 8 of 9 leaflets. CONCLUSIONS: Aortic valves reconstructed with a decellularized pericardial patch demonstrated adequate diastolic function with minimal regurgitation and resistance to calcification. Combining the Ozaki technique with this decellularized pericardial scaffold showed adequate hemodynamics, sustained mechanical integrity of the patch and limited calcification of the material. These results, together with earlier experimental and clinical data, indicate the potential of this material for aortic valve repair.
BACKGROUND: The purpose of this study was to provide a preliminary assessment of the performance of a decellularized pericardial patch in a trileaflet aortic valve reconstruction in a long-term juvenile sheep model. METHODS: A sheep surgical model was used to perform a complete trileaflet reconstruction (Ozaki technique) of the aortic valve with 3 separate pericardial patches. Valve function was assessed 1 week, 3 months, and 6 months after surgery via transthoracic echocardiography. Calcification resistance and host cell infiltration of the pericardial material were assessed at 6 months after surgery. RESULTS: Three of 6 sheep with implanted pericardial neo-cusps survived until the planned time of sacrifice after surgery, whereas 3 animals had a successful implant but died shortly after the procedure as the result of a bad recovery from cardiopulmonary bypass. Echocardiography at 6 months revealed a high coaptation area with only minimal regurgitation. In all explanted leaflets, cusp tissue was soft. There was only minimal calcification in 8 of 9 leaflets. CONCLUSIONS: Aortic valves reconstructed with a decellularized pericardial patch demonstrated adequate diastolic function with minimal regurgitation and resistance to calcification. Combining the Ozaki technique with this decellularized pericardial scaffold showed adequate hemodynamics, sustained mechanical integrity of the patch and limited calcification of the material. These results, together with earlier experimental and clinical data, indicate the potential of this material for aortic valve repair.
Authors: Annemijn Vis; Jan Cam Lammers; Roel de Vroege; Martijn Mj van Nieuwburg; Marlijn S Jansen; Joyce Mj Visser; Bart Meuris; Paul F Gründeman; Jolanda Kluin Journal: Comp Med Date: 2021-06-03 Impact factor: 0.982
Authors: Kaitlin M Whitehead; Hanifah K L Hendricks; Sirin N Cakir; Lisandra E de Castro Brás Journal: Am J Physiol Heart Circ Physiol Date: 2022-08-12 Impact factor: 5.125