Hayashi Hidenori, Contento Jacqueline, Matsushita Hiroshi, Watanabe Tatsuya, Lee Nora, Dunn Tyler, Nurminsky Katherine, Zhu Angie, Reid Emmett, Mass Paige, Cleveland Vincent, Aslan Seda, Nguyen Vivian, Kawaji Keigo, Huddle Joey, Johnson Jed, Loke Yue-Hin, Krieger Axel, Olivieri Laura, Hibino Narutoshi
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Illinois.
Department of Cardiology, Children's National Hospital, Washington, DC.
Ann Thorac Surg Short Rep. 2023 Jun 14;1(3):426-430. doi: 10.1016/j.atssr.2023.05.018. eCollection 2023 Sep.
Patient-specific, 3-dimensional printed, tissue engineered vascular grafts (3DTEVGs) are manufactured to optimize hemodynamic performance and to accommodate growth. We evaluate growth outcomes of 3DTEVGs compared with standard grafts for pulmonary artery reconstruction in porcine models.
Magnetic resonance imaging (MRI) with 4-dimensional flow data was acquired in porcine models (n = 8). 3DTEVGs guided in design by computational flow dynamics were implanted (n = 4), with polytetrafluorethylene grafts used as controls (n = 4). Postoperative MRI and histologic features of explanted grafts were evaluated after 10 weeks.
All pigs survived, with evidence of patent grafts on postoperative MRI. Graft inner diameter changes were 0.47 ± 2.31 mm in 3DTEVGs and -4.61 ± 2.15 mm in controls ( = .018). Mean main pulmonary artery wall shear stress was significantly lower in 3DTEVGs (7.12 ± 4.21 Pa) than in controls (18.15 ± 8.37 Pa; = .0396). Histologic evaluation of 3DTEVGs showed a single layer of endothelial cells, an organized smooth muscle layer, and collagen deposition with a remaining scaffold area of 21.37% ± 20.46%.
Our patient-specific 3DTEVGs demonstrated optimal anatomic fit while maintaining ideal flow dynamics and promoting appropriate neovessel formation.
定制的三维打印组织工程血管移植物（3DTEVG）旨在优化血流动力学性能并适应生长。我们评估了在猪模型中，与用于肺动脉重建的标准移植物相比，3DTEVG的生长结果。
在猪模型（n = 8）中获取具有四维血流数据的磁共振成像（MRI）。植入由计算流体动力学指导设计的3DTEVG（n = 4），使用聚四氟乙烯移植物作为对照（n = 4）。10周后评估术后MRI和取出移植物的组织学特征。
所有猪均存活，术后MRI显示移植物通畅。3DTEVG的移植物内径变化为0.47±2.31 mm，对照组为-4.61±2.15 mm（P = .018）。3DTEVG的平均主肺动脉壁剪切应力（7.12±4.21 Pa）显著低于对照组（18.15±8.37 Pa；P = .0396）。3DTEVG的组织学评估显示单层内皮细胞、有组织的平滑肌层和胶原沉积，剩余支架面积为21.37%±20.46%。
我们的定制3DTEVG在保持理想血流动力学并促进适当的新血管形成的同时，展示了最佳的解剖适应性。
