Document Detail


Viable vascularized autologous patch for transmural myocardial reconstruction.
MedLine Citation:
PMID:  19369090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Various patch materials currently used for cardiac reconstruction represent non-viable tissue with high susceptibility to infection and degeneration. We therefore introduce an innovative, autologous vascularized matrix with high regenerative potential for myocardial reconstruction. METHODS: Autologous small bowel segments without mucosa, but with both the adjacent jejunal artery and vein, were harvested and used in a single-stage procedure for the replacement of right ventricular transmural defects (2 cm x 3 cm) in pigs (group A; n = 3). The autografts were revascularized by connecting jejunal vessels to the right internal thoracic artery and vein. Autologous pericardium was used as controls (group B; n = 3). All procedures were performed on beating hearts using a right heart bypass. After explantation (up to 6 months), the patches were investigated by standard histological analyses, immunohistochemistry and confocal microscopy. RESULTS: Postoperative complications, for example excessive bleeding, graft rupture or dislodgement due to the dynamic cardiac contractions, did not occur. In group A, newly formed cardiomyocytes positively stained for Nkx 2.5 and myosin heavy chain were identified 1 month after operation. The cardiomyocytes were localized in close proximity to mesenteric capillaries in a disseminated-like pattern and showed a strong tendency to form islets. In contrast, explanted pericardial patches appeared as fibrotic tissue without evidence of myocardial cells inside the patch. CONCLUSION: We developed a novel autologous graft with preserved vascularity that can be used for myocardial grafting. This vascularized matrix undergoes autologous repopulation with cardiomyocytes after transmural myocardial replacement. Vascularization represents an important prerequisite for myocardial guided tissue regeneration.
Authors:
Igor Tudorache; Sava Kostin; Tanja Meyer; Omke Teebken; Christoph Bara; Andres Hilfiker; Axel Haverich; Serghei Cebotari
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-14
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  36     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-17     Completed Date:  2009-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  306-11; discussion 311     Citation Subset:  IM    
Affiliation:
Department of Cardio-Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Surgical Procedures / methods*
Graft Survival
Guided Tissue Regeneration / methods*
Intestine, Small / blood supply,  transplantation*
Microscopy, Confocal
Myocytes, Cardiac / pathology
Postoperative Complications
Regeneration
Sus scrofa

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