Abstract 10935: Long-Term Maturity and Extensibility of an In S itu Regenerated Aortic Wall Induced by a Novel Synthetic Hybrid Knit

• Published in: Circulation (New York, N.Y.) Vol. 146; no. Suppl_1
• Main Authors: Nemoto, Shintaro, Konishi, Hayato, Suzuki, Tatsuya, Suzuki, Akiyo, Katsumata, Takahiro, Yamaguchi, Ayuko, Hibino, Kiyoe, Sakaue, Takeshi
• Format: Journal Article
• Language: English
• Published: 08.11.2022
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.146.suppl_1.10935

Abstract only Introduction: A novel synthetic hybrid warp-knit with non-biodegradable (polyethylene terephthalate: PET) and biodegradable (poly-L-lactic acid: PLLA) yarns coated with crosslinked gelatin (OFT) has been used to induce in situ canine aortic wall regeneration. A recent pivotal clinical trial in Japan revealed the effectiveness and safety of this approach in pediatric cardiac surgery. Hypothesis: The regenerated aortic wall will show long-term extensibility with tissue maturation as the biodegradable yarns dissolve. Methods: An oval-shaped defect created in the canine descending aorta was filled with a patch using OFT or a currently used material (ePTFE or bovine pericardium). At 2 to 4 years after implantation, the patch-implanted aorta was explanted for histological examination and stretch-testing. Results: OFT induced a well-matured aortic wall characterized by a layered endothelium and an intima of aligned collagen fibers and smooth muscle. Bridging tissues containing capillaries developed across the remaining non-absorbable yarns. Material degradation indicated by calcium deposition was not apparent in the OFT-regenerated wall, but was clear in walls generated by currently used materials, in which only avascular collagen layers developed. The OFT-regenerated wall maintained physiological strength and was extensible by 80 to 200% of the starting width. Conclusions: The aortic wall regenerated over the OFT patch continued to mature without material degradation in the long term and showed favorable extensibility that could not be achieved with currently used materials. These long-term findings provide strong support for the suitability of use of OFT as a surgical material in pediatric cardiac surgery.