Abstract
We have developed a new biodegradable scaffold that does not require any cell seeding to create an in-situ tissue-engineering vasculature (iTEV). Animal experiments were conducted to test its characteristics and long-term efficacy. An 8-mm tubular biodegradable scaffold, consisting of polyglycolide knitted fibers and an L-lactide and ε-caprolactone copolymer sponge with outer glycolide and ε-caprolactone copolymer monofilament reinforcement, was implanted into the inferior vena cava (IVC) of 13 canines. All the animals remained alive without any major complications until euthanasia. The utility of the iTEV was evaluated from 1 to 24 months postoperatively. The elastic modulus of the iTEV determined by an intravascular ultrasound imaging system was about 90% of the native IVC after 1 month. Angiography of the iTEV after 2 years showed a well-formed vasculature without marked stenosis or thrombosis with a mean pressure gradient of 0.51±0.19 mmHg. The length of the iTEV at 2 years had increased by 0.48±0.15 cm compared with the length of the original scaffold (2–3 cm). Histological examinations revealed a well-formed vessel-like vasculature without calcification. Biochemical analyses showed no significant differences in the hydroxyproline, elastin, and calcium contents compared with the native IVC. We concluded that the findings shown above provide direct evidence that the new scaffold can be useful for cell-free tissue-engineering of vasculature. The long-term results revealed that the iTEV was of good quality and had adapted its shape to the needs of the living body. Therefore, this scaffold would be applicable for pediatric cardiovascular surgery involving biocompatible materials.
Highlights
The use of foreign materials is necessary to repair complex heart defects
We previously reported the advantages of using biodegradable scaffolds seeded with autologous cells as tissue-engineered vascular autografts (TEVAs) in canine models [1,2,3] and in a human clinical study [1,4,5]
To overcome the graft stenosis of TEVAs, we explored a new scaffold without cell seeding, and achieved acceptable long-term results as evaluated by new techniques involving an intravascular ultrasound imaging system
Summary
The use of foreign materials is necessary to repair complex heart defects. the materials that are commonly used are not biocompatible with the host tissue and do not have the ability to change their shape as the host grows. We evaluated the long-term outcomes, usefulness, and basic characteristics of an in-situ tissue-engineering vasculature (iTEV) constructed through cell-free and direct implantation of the new biodegradable scaffold in a canine model.
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