Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33600 Pessac, France.
Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modelling Institute, Fondation Bordeaux Université, 33600 Pessac, France; Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, INSERM, 33000 Bordeaux, France.
Arch Cardiovasc Dis. 2020 Aug-Sep;113(8-9):503-512. doi: 10.1016/j.acvd.2020.03.022. Epub 2020 Jul 24.
Percutaneous device closure of atrial septal defect (ASD) is the gold-standard treatment, but several delayed complications may occur as a result of incomplete device endothelialisation.
In this in vitro study, we compared three ASD closure devices [Nit-Occlud® ASD-R (device 1); Hyperion™ ASDO (device 2); and Amplatzer™ Septal Occluder (device 3)] in terms of the endothelialisation process, using human endothelial progenitors cells (EPCs), and haemocompatibility.
EPCs from umbilical cord blood were extracted, cultured and characterised. Device samples were seeded with 100,000 cells/cm. EPC adhesion was investigated at 3 and 24hours, and EPC proliferation was monitored, which allowed longitudinal follow-up (days 1-12). Haemocompatibility of device samples was assessed using a complement C3a assay and platelet and coagulation activation.
With regard to EPC adhesion and proliferation, no statistically significant differences were found between the three devices. We observed for each device a significant time-dependent EPC proliferation, appearing at day 8 for devices 2 and 3 and day 10 for device 1. No complement or platelet activation occurred within 15minutes of contact with devices. However, there was minimal activation of coagulation for the three devices.
In this in vitro study we showed that, despite the three ASD occluders having different device designs and coatings, adhesion and proliferation of human endothelial cells was similar for all devices. This should be further confirmed by similar studies including shear stress forces and anti-thrombotic treatments.
经皮装置闭合房间隔缺损（ASD）是金标准治疗方法，但由于装置不完全内皮化，可能会出现几种迟发性并发症。
在这项体外研究中，我们比较了三种 ASD 闭合装置[Nit-Occlud® ASD-R（装置 1）；Hyperion™ ASDO（装置 2）和 Amplatzer™ 房间隔封堵器（装置 3）]在人内皮祖细胞（EPC）和血液相容性方面的内皮化过程。
从脐带血中提取、培养和鉴定 EPC。将 100,000 个细胞/cm 的细胞接种到装置样本上。在 3 小时和 24 小时时研究 EPC 黏附，监测 EPC 增殖，允许进行纵向随访（第 1-12 天）。使用补体 C3a 测定法和血小板及凝血激活来评估装置样本的血液相容性。
就 EPC 黏附和增殖而言，三种装置之间没有统计学上的显著差异。我们观察到每种装置都有明显的 EPC 增殖，装置 2 和 3 在第 8 天，装置 1 在第 10 天出现增殖。与装置接触 15 分钟内，未发生补体或血小板激活。然而，三种装置都出现了轻微的凝血激活。
在这项体外研究中，我们表明，尽管三种 ASD 封堵器具有不同的装置设计和涂层，但所有装置的人内皮细胞黏附和增殖相似。这应该通过包括切应力和抗血栓治疗在内的类似研究进一步证实。
