Fujimoto Kazuro L, Guan Jianjun, Oshima Hideki, Sakai Tetsuro, Wagner William R
Department of Surgery, McGowan Institute for Regenerative Medicine, Pittsburgh, Pennsylvania, USA.
Ann Thorac Surg. 2007 Feb;83(2):648-54. doi: 10.1016/j.athoracsur.2006.06.085.
Several synthetic materials have been used for cardiac reconstruction in patients with complex congenital heart defects. These materials are not viable, do not grow with children, and may necessitate reoperation. We report here on the cardiac implantation of a recently developed, degradable porous material designed to facilitate cellular ingrowth during the healing process.
An elastomeric, biodegradable polyester urethane urea (PEUU) was processed into circular scaffolds and used to replace a surgical defect in the right ventricular outflow tract of adult rats. Control rats were implanted with expanded polytetrafluoroethylene. Histologic evaluation was performed at 4, 8, and 12 weeks postsurgery.
All animals survived the surgery. Both PEUU and expanded polytetrafluoroethylene were encapsulated with fibrous tissue and had complete endothelialization on the endocardial surface with no aneurysm formation or thrombus noted. With PEUU patching, fibroblast ingrowth occurred at 4 weeks, increasing with time. In contrast, expanded polytetrafluoroethylene patches exhibited no ingrowth and elicited local inflammation that moderated with time.
The PEUU patch demonstrated suitable mechanical properties and biocompatible characteristics in the right ventricular outflow tract replacement model, permitting cellular integration and endocardial endothelialization with minimal inflammation. Future application of this material as a cardiovascular scaffold seems promising.
几种合成材料已被用于复杂先天性心脏缺陷患者的心脏重建。这些材料没有活性，不会随着儿童生长，可能需要再次手术。我们在此报告一种最近开发的可降解多孔材料在心脏植入的情况，该材料旨在促进愈合过程中的细胞向内生长。
一种弹性、可生物降解的聚酯聚氨酯脲（PEUU）被加工成圆形支架，并用于替代成年大鼠右心室流出道的手术缺损。对照大鼠植入膨体聚四氟乙烯。在术后4周、8周和12周进行组织学评估。
所有动物均在手术中存活。PEUU和膨体聚四氟乙烯均被纤维组织包裹，心内膜表面完全内皮化，未发现动脉瘤形成或血栓。使用PEUU修补时，成纤维细胞在4周时向内生长，并随时间增加。相比之下，膨体聚四氟乙烯补片没有向内生长，并引发局部炎症，炎症随时间减轻。
PEUU补片在右心室流出道置换模型中表现出合适的力学性能和生物相容性特征，允许细胞整合和心内膜内皮化，炎症最小。这种材料作为心血管支架的未来应用似乎很有前景。
