Jedrzejczyk Johannes H, Andersen Frederik T, Petersen Jacob, Kaspersen Alexander Emil, Sahana Urjosee, Skov Søren N, Væsel Jens T, Hasenkam J Michael, Tjørnild Marcell J
Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
J Cardiovasc Transl Res. 2025 Apr;18(2):268-279. doi: 10.1007/s12265-024-10572-0. Epub 2024 Oct 28.
To assess the mechanical properties of small intestinal submucosal extracellular matrix (SIS-ECM) iterations and choose the optimal version for evaluating functional geometrics after posterior mitral valve reconstruction. Four SIS-ECM versions (2- and 4-ply vacuum-pressed and lyophilized) underwent uniaxial tensile testing. A posterior mitral valve reconstruction patch was developed based on MRI scans (n = 5). Posterior mitral valve reconstruction using 2-ply vacuum-pressed SIS-ECM was performed (n = 7), and geometrics were evaluated using a modified left heart simulator. The vacuum-pressed iterations displayed superior maximum stress values compared to lyophilized (2-ply: median [IQR], 15.8 [15.2-19.0] vs 7.9 [7.3-8.3] MPa, p < 0.001; 4-ply: median (IQR), 15.8 -[14.6-22.0] vs 7.9 [7.6-8.4] MPa). All reconstructed valves were competent with preserved total leaflet area, but individual leaflet segment areas were redistributed. Posterior mitral valve reconstruction with our 2-ply vacuum-pressed SIS-ECM patch design was feasible in vitro. Further in vivo evaluation is warranted.
评估小肠黏膜下层细胞外基质（SIS - ECM）迭代产品的力学性能，并选择最佳版本用于评估二尖瓣后叶重建后的功能几何学。对四种SIS - ECM版本（2层和4层真空压制及冻干）进行单轴拉伸测试。基于MRI扫描（n = 5）开发了二尖瓣后叶重建补片。使用2层真空压制的SIS - ECM进行二尖瓣后叶重建（n = 7），并使用改良的左心模拟器评估几何学。与冻干版本相比，真空压制的迭代产品显示出更高的最大应力值（2层：中位数[四分位间距]，15.8[15.2 - 19.0]对7.9[7.3 - 8.3]MPa，p < 0.001；4层：中位数（四分位间距），15.8 -[14.6 - 22.0]对7.9[7.6 - 8.4]MPa）。所有重建瓣膜功能良好，总瓣叶面积得以保留，但各瓣叶节段面积重新分布。采用我们的2层真空压制SIS - ECM补片设计进行二尖瓣后叶重建在体外是可行的。有必要进行进一步的体内评估。
