Bacterial Adherence to Graft Tissues in Static and Flow Conditions

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 155; no. 1; pp. 325 - 332.e4
• Main Authors: Veloso, Tiago Rafael, PhD, Claes, Jorien, PhD, Van kerckhoven, Soetkin, Ditkowski, Bartosz, PhD, Hurtado-Aguilar, Luis G., MSc, Jockenhoevel, Stefan, MD, PhD, Mela, Petra, PhD, Jashari, Ramadan, MD, PhD, Gewillig, Marc, MD, PhD, Hoylaerts, Marc F., PhD, Meyns, Bart, MD, PhD, Heying, Ruth, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2018
• Subjects: Cardiothoracic Surgery; congenital heart disease; congenital heart disease surgery; endocarditis; prosthetic heart valve; valved conduit; Right ventricular outflow tract; Endothelial cell; ClfA; S. aureus Clumping factor A; S. aureus protein A; FnbpA; Congenital heart disease; Prosthetic heart valves; BP; BJV; RVOT; bovine jugular vein; Scanning electronic microscope; CFU; Phosphate saline buffer; Valved conduits; Von Willebrand factor; Infective endocarditis; Extracellular matrix; SdrCDE; IE; MSB; EC; PBS; Poly-(methyl methacrylate); VWF; CH; SpA; Cryopreserved homograft; Sodium chloride; Bovine pericardium; ECM; Martius, Scarlet and Blue staining; PMMA; S. aureus Fibronectin-binding protein A; Endocarditis; NaCl; colony-forming unit; SEM; Congenital heart disease surgery; S. aureus serine-aspartate repeat proteins C, D and E; prosthetic heart valve; congenital heart disease surgery; valved conduit; congenital heart disease; endocarditis
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2017.06.014

Abstract Objective Various conduits or stent-mounted valves are used as pulmonary valve graft tissues for Right Ventricular Outflow Tract reconstruction with good hemodynamic results. Valve replacement inherits an increased risk of infective endocarditis (IE). Recent observations rose awareness to IE after transcatheter implantation of a stent-mounted bovine jugular vein valve. The present study focuses on the susceptibility of graft tissue surfaces to bacterial adherence as a potential risk factor for subsequent IE. Methods Staphylococcus aureus , S. epidermidis and Streptococcus sanguinis adhesion to bovine pericardium (BP) patch, bovine jugular vein (BJV) and cryopreserved homograft (CH) tissues was quantified under static and shear stress conditions. Microscopic analysis and histology were performed to evaluate bacterial adhesion to matrix components. Results In general, similar bacteria numbers were recovered from CH and BJV tissue surface for all strains, especially in flow conditions. Static bacterial adhesion to CH wall was lower for S. sanguinis adhesion ( P <0.05 vs. BP patch). Adhesion to BJV wall, CH wall and leaflet were found to be decreased for S. epidermidis in static conditions ( P <0.05 vs. BP patch). Bacterial adhesion under shear stress indicates a similar bacterial adhesion to all tissues, except for a decrease to BJV wall after S. sanguinis incubation. Microscopic analysis shows the importance of matrix component exposure for bacterial adherence to CH. Conclusions Our data exhibit evidence that the surface composition of BJV and CH tissues itself, bacterial surface proteins or shear forces per se are not the prime determinants during initial bacterial adherence.