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牛心包与猪心包的对比研究,突出其在制造经皮心血管植入物方面的潜在优势。

A comparative study of bovine and porcine pericardium to highlight their potential advantages to manufacture percutaneous cardiovascular implants.

机构信息

1Center of LOEX, Laval University, Quebec (QC), Canada.

出版信息

J Biomater Appl. 2013 Nov;28(4):552-65. doi: 10.1177/0885328212465482. Epub 2012 Nov 8.

Abstract

RATIONALE

Prosthetic heart valves designed to be implanted percutaneously must be loaded within delivery catheters whose diameter can be as low as 18 F (6 mm). This mandatory crimping of the devices may result in deleterious damages to the tissues used for valve manufacturing. As bovine and porcine pericardial tissue are currently given preference because of their excellent availability and traceability, a preliminary comparative study was undertaken to highlight their potential advantages.

MATERIALS AND METHODS

Bovine and pericardium patches were compared morphologically (light microscopy, scanning electron microscopy and transmission electron microscopy). The acute thrombogenicity of both materials was measured in term of platelet uptake and observed by scanning electron microscopy, porcine intact and injured arteries being used as controls. The pericardium specimens were also subjected to uniaxial tensile tests to compare their respective mechanical characteristics.

RESULTS

Both pericardiums showed a layered architecture of collagen bundles presenting some interstitial cells. They displayed wavy crimps typical of an unloaded collagenous tissue. The collagen bundles were not bound together and the fibrils were parallel with characteristic periodicity patterns of cross striations. The mesothelial cells found in vivo on the serous surface were no longer present due to tissue processing, but the adjacent structure was far more compacted when compared to the fibrous side. The fibrinocollagenous surfaces were found to be more thrombogenic for both bovine and porcine tissues and the serous side of the porcine pericardium retained more platelets when compared to the bovine samples, making the acute thrombogenicity more important in the porcine pericardium.

CONCLUSION

Both bovine and porcine pericardium used in cardiovascular implantology can be selected to manufacture percutaneous heart valves. The selection of one pericardium preferably to the other should deserve additional testing regarding the innocuousness of crimping when loaded in delivery catheters and the long-term durability after percutaneous deployment.

摘要

背景

设计经皮植入的人工心脏瓣膜必须在输送导管内装载,输送导管的直径可以低至 18 F(6 毫米)。这种对器械的强制性卷曲可能会对用于瓣膜制造的组织造成有害损害。由于牛心包和猪心包组织因其出色的可用性和可追溯性而目前被优先考虑,因此进行了一项初步的比较研究,以突出它们的潜在优势。

材料和方法

对牛心包和心包片进行了形态学比较(光学显微镜、扫描电子显微镜和透射电子显微镜)。通过扫描电子显微镜测量了两种材料的急性血栓形成性,以血小板摄取为指标,并使用完整的猪动脉和受伤的猪动脉作为对照。还对心包标本进行了单轴拉伸试验,以比较它们各自的机械特性。

结果

两种心包均显示出胶原束的层状结构,其中存在一些间质细胞。它们呈现出波浪形的卷曲,这是未加载胶原组织的典型特征。胶原束没有结合在一起,纤维呈平行排列,具有特征性的横纹周期性图案。由于组织处理,活体中在浆膜表面发现的间皮细胞不再存在,但与纤维侧相比,相邻结构更加紧密。发现无论是牛心包还是猪心包,纤维蛋白原胶原表面对两者都具有更高的血栓形成性,并且与牛心包样本相比,猪心包的浆膜侧保留了更多的血小板,这使得猪心包的急性血栓形成性更为重要。

结论

心血管植入物学中使用的牛心包和猪心包均可用于制造经皮心脏瓣膜。在选择一种心包优于另一种心包时,应根据在输送导管中装载时的卷曲无害性以及经皮部署后的长期耐久性进行额外的测试。

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