Total cavopulmonary connection with a new bioabsorbable vascular graft: First clinical experience.

Bockeria, Leo A; Svanidze, Oleg; Kim, Alex; Shatalov, Konstantin; Makarenko, Vladimir; Cox, Martijn; Carrel, Thierry (2017). Total cavopulmonary connection with a new bioabsorbable vascular graft: First clinical experience. The journal of thoracic and cardiovascular surgery, 153(6), pp. 1542-1550. Elsevier 10.1016/j.jtcvs.2016.11.071

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OBJECTIVES To assess safety and clinical performance of a novel bioabsorbable vascular graft in pediatric patients with univentricular cardiac malformation who received surgical correction via an extracardiac cavopulmonary conduit. METHODS The implanted graft material is designed to attract patient's own cells and proteins, which trigger a cascade of physiological events leading to endogenous tissue restoration. As the graft resorbs progressively after implantation, components of native tissue including collagen, endothelial lining, and capillary blood vessels develop and organize into a natural tissue. Five patients (aged 4-12 years) received this new vascular graft as interposition between the inferior vena cava and the pulmonary artery. They were followed up to 12 months after surgery. The conduit was assessed by echocardiography, computed tomography and magnetic resonance imaging, including 4-dimensional flow. RESULTS All patients recovered from the procedure without complications. No device-related adverse events were reported. Two patients required interventional occlusion of aortopulmonary collaterals. At 12 months, there was a significant improvement in the patients' general condition. Imaging studies demonstrated anatomical (conduit diameter, length and wall thickness) and functional (blood flow pattern) stability of the bioabsorbable grafts in all patients with no significant changes at 12 months compared with early postoperative data. CONCLUSIONS Initial clinical experience with a novel absorbable graft underlines the potential of this new material to improve cardiac and vascular surgical procedures. In addition, better biocompatibility may reduce permanent implant-related complications. A longer follow-up is needed to assess the long-term effectiveness of biodegradable vascular grafts, including their ability to grow.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1097-685X

Publisher:

Elsevier

Language:

English

Submitter:

Daniela Huber

Date Deposited:

06 Sep 2017 17:23

Last Modified:

06 Sep 2017 17:23

Publisher DOI:

10.1016/j.jtcvs.2016.11.071

PubMed ID:

28314534

Uncontrolled Keywords:

bioabsorbable polymer conduit congenital heart disease pulmonary artery graft Fontan procedure tissue engineering

BORIS DOI:

10.7892/boris.98531

URI:

https://boris.unibe.ch/id/eprint/98531

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