Dudenhöffer Daniel W, Laschke Matthias W, Giebels Christian, Karliova Irem, Schneider Ulrich, Menger Michael D, Schäfers Hans-Joachim
Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany.
Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany.
Thorac Cardiovasc Surg. 2020 Oct;68(7):575-583. doi: 10.1055/s-0038-1675595. Epub 2018 Nov 20.
Expanded polytetrafluoroethylene (ePTFE) is a suture material for annuloplasty in aortic valve repair. For this particular application, it should induce minimal local stress and promote rapid tissue incorporation. To achieve this, a novel ePTFE suture with a larger diameter and high porosity in its midsection has been developed. Herein, we analyzed the acute and chronic tissue reaction to this suture material compared with a commercially available control ePTFE suture.
Novel and control suture samples were implanted into dorsal skinfold chambers of BALB/c mice to analyze the early inflammatory response using intravital fluorescence microscopy over 14 days. Additional suture samples were implanted for 4 and 12 weeks in the flank musculature of mice and analyzed by histology and immunohistochemistry.
The implantation of novel and control ePTFE suture into the dorsal skinfold chamber did not induce an acute inflammation, as indicated by physiological numbers of rolling and adherent leukocytes in all analyzed venules. Chronic implantation into the flank musculature showed a better tissue incorporation of the novel ePTFE suture with more infiltrating cells and a higher content of Sirius red+ collagen fibers when compared with controls. Cell proliferation and viability as well as numbers of recruited CD68+ macrophages, myeloperoxidase+ neutrophilic granulocytes and CD3+ lymphocytes did not significantly differ between the groups.
The novel ePTFE suture exhibits a good in vivo biocompatibility which is comparable to that of the control suture. Due to its improved tissue incorporation, it may provide a better long-term stability during annuloplasty.
膨体聚四氟乙烯（ePTFE）是一种用于主动脉瓣修复中瓣环成形术的缝合材料。对于这种特殊应用，它应诱导最小的局部应力并促进组织快速整合。为实现这一目标，已开发出一种新型的ePTFE缝合线，其直径更大且中段具有高孔隙率。在此，我们将这种缝合材料与市售对照ePTFE缝合线进行比较，分析了其对急性和慢性组织的反应。
将新型和对照缝合线样本植入BALB/c小鼠的背部皮褶腔，通过活体荧光显微镜在14天内分析早期炎症反应。另外的缝合线样本在小鼠的侧腹肌肉组织中植入4周和12周，并通过组织学和免疫组织化学进行分析。
将新型和对照ePTFE缝合线植入背部皮褶腔未引发急性炎症，所有分析的小静脉中滚动和黏附白细胞的生理数量表明了这一点。与对照相比，长期植入侧腹肌肉组织显示新型ePTFE缝合线的组织整合更好，有更多浸润细胞以及更高含量的天狼星红+胶原纤维。两组之间的细胞增殖和活力以及募集的CD68+巨噬细胞、髓过氧化物酶+中性粒细胞和CD3+淋巴细胞数量没有显著差异。
新型ePTFE缝合线在体内表现出良好的生物相容性，与对照缝合线相当。由于其改善的组织整合，它可能在瓣环成形术期间提供更好的长期稳定性。
