Biodegradable Versus Non-Biodegradable Cardiac Support Device for Treating Ischemic Cardiomyopathy in a Canine Heart

• Published in: Seminars in thoracic and cardiovascular surgery
• Main Authors: Kitahara, Mutsunori, MD, Miyagawa, Shigeru, MD, PhD, Fukushima, Satsuki, MD, PhD, Saito, Atsuhiro, PhD, Shintani, Ayumi, PhD, MPH, Akita, Toshiaki, MD, PhD, Sawa, Yoshiki, MD, PhD
• Format: Journal Article
• Language: English
• Published: 2017
• Subjects: Cardiothoracic Surgery; PRSW; RV; deceleration time; rate of change in pressure; myocardial infarction; dp/dt; LVEF; LVESV; Tau; LV; left ventricular ejection fraction; left ventricular end-diastolic volume; DcT; LVEDV; left ventricular; MI; left ventricular end-systolic volume; time constant of relaxation; EDPVR; end-diastolic pressure-volume relationship; cardiac support device; MDCT; Ees; right ventricle; multi-detector computed tomography; end-systolic elastance; preload recruitable stroke work; dog
• ISSN: 1043-0679
• DOI: 10.1053/j.semtcvs.2017.01.016

Abstract Objective The clinical studies of the efficacy of the non-biodegradable Corcap device have shown inconsistent findings, at least in part, because of device-related impairment of diastolic cardiac function. We hypothesized that use of biodegradable material for the cardiac support device could contribute to an improvement in the diastolic function of the failing heart. Methods Polyglycolic acid and polyethyleneterephthalate were used to prepare biodegradable and non-biodegradable cardiac support devices, respectively. Twelve-month-old beagles underwent anterior coronary artery ligation. One week after, beagles were randomly assigned for implantation of a biodegradable cardiac support device (n = 7), non-biodegradable cardiac support device (n = 8) or sham operation (n = 8). Results Twelve weeks after coronary artery ligation, the biodegradable group showed a significantly greater recovery of echocardiographical ejection fraction than the non-biodegradable and the sham groups (40% ± 3.3%, 32% ± 2.5% and 29 ± 2.6%, respectively). Of note, diastolic function, as assessed by Tau, -dp/dt min, and EDPVR in the cardiac catheter, was significantly better in both left and right ventricles in the biodegradable group than in the non-biodegradable group. Moreover, global end-systolic wall stress was significantly lower in the two device groups than in the sham group (P < 0.03). Furthermore, global end-diastolic wall stress was significantly less in the biodegradable device group than in the non-biodegradable group (P < 0.02). Conclusions The cardiac support devices made of biodegradable material were more effective in improving systolic function, with preservation of diastolic function in the canine chronic infarct heart, than devices made of non-biodegradable material.