TY - JOUR

T1 - Stabilisation of a Segment of Autologous Vascularised Stomach as a Patch for Myocardial Reconstruction with Degradable Magnesium Alloy Scaffolds in a Swine Model

AU - Schilling, Tobias

AU - Bauer, Michael

AU - Hartung, Dagmar

AU - Brandes, Gudrun

AU - Tudorache, Igor

AU - Cebotari, Serghei

AU - Meyer, Tanja

AU - Wacker, Frank

AU - Haverich, Axel

AU - Hassel, Thomas

N1 - Funding information: This research was funded by German Research Foundation, SFB599, project R7. The excellent technical support of Klaus Höffler, Petra Ziehme, Astrid Dierks-Ketterkat, and Rosi Katt of the Department of Cardiovascular, Thoracic, and Transplantation Surgery, as well as Annette Oestereich and Frank Schröder of the Institute for Radiology of Hannover Medical School is highly appreciated. We also thank Luigi Angrisani and Dr. Christoph Klose of the Institut für Werkstoffkunde (Materials Science) of Leibniz Universität Hannover for facilitating the µ-CT investigations. Not least, we are grateful to Prof. Andre Bleich, Prof. Klaus Otto, Karl-Heinz Napierski, and Paul Zerbe of the central animal facility of Hannover Medical School for their competent support in performing the animal surgery and providing the excellent laboratory infrastructure. Finally, we are grateful to the German Research Foundation for funding this project. Funding: This research was funded by German Research Foundation, SFB599, project R7.

PY - 2020/5/29

Y1 - 2020/5/29

N2 - In patients with severe heart failure, the surgical reconstruction of the damaged myocardium with regenerative biological grafts is an innovative therapeutic option. However, natural patch materials are often too delicate for a full wall repair of the left ventricle. A degradable magnesium scaffold could provide temporary mechanical stability until the sufficient physiological remodeling of such grafts. An autologous vascularised gastric patch was employed for the reconstruction of the left ventricular myocardium in a porcine model. Magnesium alloy (LA63) scaffolds were fixed over the biological patch. The function of the implant was assessed via magnetic resonance imaging. Angiography was carried out to detect a connection between the gastric and coronary vasculature. The explants were examined via µ-computer tomography and light microscopy. All the test animals survived. The prostheses integrated biologically and functionally into the myocardium. No rupture of the prostheses occurred. An anastomosis of the gastric and coronary vasculature had developed. The magnesium scaffolds degraded, on average, to 30.9% of their original volume. This novel technique responds to the increasing demand for regenerative myocardial grafts. The magnesium scaffolds’ biocompatibility and degradation kinetics, as well as their stabilizing effects, indicate their applicability in the surgical treatment of terminal heart failure.

AB - In patients with severe heart failure, the surgical reconstruction of the damaged myocardium with regenerative biological grafts is an innovative therapeutic option. However, natural patch materials are often too delicate for a full wall repair of the left ventricle. A degradable magnesium scaffold could provide temporary mechanical stability until the sufficient physiological remodeling of such grafts. An autologous vascularised gastric patch was employed for the reconstruction of the left ventricular myocardium in a porcine model. Magnesium alloy (LA63) scaffolds were fixed over the biological patch. The function of the implant was assessed via magnetic resonance imaging. Angiography was carried out to detect a connection between the gastric and coronary vasculature. The explants were examined via µ-computer tomography and light microscopy. All the test animals survived. The prostheses integrated biologically and functionally into the myocardium. No rupture of the prostheses occurred. An anastomosis of the gastric and coronary vasculature had developed. The magnesium scaffolds degraded, on average, to 30.9% of their original volume. This novel technique responds to the increasing demand for regenerative myocardial grafts. The magnesium scaffolds’ biocompatibility and degradation kinetics, as well as their stabilizing effects, indicate their applicability in the surgical treatment of terminal heart failure.

KW - Cardiac surgery

KW - Degradation kinetics of magnesium

KW - Magnesium scaffolds

KW - Myocardial prosthesis

KW - Regenerative therapy

KW - Terminal heart failure

UR - http://www.scopus.com/inward/record.url?scp=85085711096&partnerID=8YFLogxK

U2 - 10.3390/cryst10060438

DO - 10.3390/cryst10060438

M3 - Article

AN - SCOPUS:85085711096

VL - 10

JO - CRYSTALS

JF - CRYSTALS

SN - 2073-4352

IS - 6

M1 - 438

ER -