Bacterial cellulose as a promising material for pulmonary valve prostheses: In vivo study in a sheep model.

Autor: Siondalski P; Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland., Kołaczkowska M; Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland., Bieńkowski M; Department of Patomorphology, Medical University of Gdańsk, Gdańsk, Poland., Pęksa R; Department of Patomorphology, Medical University of Gdańsk, Gdańsk, Poland., Kowalik MM; Department of Cardiac Anesthesiology, Medical University of Gdańsk, Gdańsk, Poland., Dawidowska K; Medical Engineering Division, Maritime Advanced Research Centre, Gdańsk, Poland., Vandendriessche K; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium., Meuris B; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: Journal of biomedical materials research. Part B, Applied biomaterials [J Biomed Mater Res B Appl Biomater] 2024 Jan; Vol. 112 (1), pp. e35355.
DOI: 10.1002/jbm.b.35355
Abstrakt: Objectives: Currently, no consensus exists regarding the most durable prosthesis for pulmonary valve replacement. Bacterial cellulose is a resistant, nonbiodegradable, nonpyrogenic bioimplant with low hemolysis and clotting properties. We hypothesized that bacterial cellulose heart valve prostheses could be an attractive alternative for pulmonary valve replacement.
Methods: We conducted a large animal model experiment in three adult sheep. The animals underwent open-heart surgery and cardiopulmonary bypass for bacterial cellulose conduit implantation in the pulmonary position. The sheep were followed for seven months, and clinical and laboratory parameters were analyzed. Echocardiographic evaluations were performed at 3 and 7 months. After seven months, the sheep were sacrificed and an autopsy was performed. The explanted conduits were radiologically and histopathologically analyzed.
Results: All sheep survived the operation, showing good recovery and normal health status; no adverse events were noted during the 7-month postoperative follow-up. Interval laboratory findings were normal with no signs of hemolysis or infection. Echocardiographic analysis after 7 months revealed a normal mean pressure gradient with excellent cusp motion and coaptation; a trace of regurgitation was found in two sheep. X-ray analysis of the explanted conduits revealed no structural defects in the leaflets with minimal calcification. Histological examination showed slight thickening of the conduit by pannus formation. No material failure, no calcification inside the material, and only minor calcification extrinsic to the matrix were observed.
Conclusions: This pilot study provides evidence that bacterial cellulose may be suitable for pulmonary valve prostheses and surgical pulmonary artery plasty. Further studies on the high pressure side of the left heart are needed.
(© 2024 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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