Patient-specific tissue engineered vascular graft for aortic arch reconstruction
Authors
Hidenori Hayashi, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Jacqueline Contento, Department of Cardiology, Children's National Hospital, Washington, DC.
Hiroshi Matsushita, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Paige Mass, Department of Cardiology, Children's National Hospital, Washington, DC.
Vincent Cleveland, Department of Cardiology, Children's National Hospital, Washington, DC.
Seda Aslan, Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Md.
Amartya Dave, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Raquel Dos Santos, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Angie Zhu, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Emmett Reid, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Tatsuya Watanabe, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Nora Lee, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Tyler Dunn, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Umar Siddiqi, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Katherine Nurminsky, Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Vivian Nguyen, Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Ill.
Keigo Kawaji, Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Ill.
Joey Huddle, Nanofiber Solutions, LLC, Dublin, Ohio.
Luka Pocivavsek, Division of Vascular Surgery, Department of Surgery, University of Chicago, Chicago, Ill.
Jed Johnson, Nanofiber Solutions, LLC, Dublin, Ohio.
Mark Fuge, Department of Mechanical Engineering, University of Maryland, College Park, Md.
Yue-Hin Loke, Department of Cardiology, Children's National Hospital, Washington, DC.
Axel Krieger, Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Md.
Laura Olivieri, Department of Pediatric Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa.
Narutoshi Hibino, Advocate Health - MidwestFollow
Recommended Citation
Hayashi H, Contento J, Matsushita H, et al. Patient-specific tissue engineered vascular graft for aortic arch reconstruction. JTCVS Open. 2024;18:209-220. Published 2024 Feb 27. doi:10.1016/j.xjon.2024.02.012
Abstract
Objectives:The complexity of aortic arch reconstruction due to diverse 3-dimensional geometrical abnormalities is a major challenge. This study introduces 3-dimensional printed tissue-engineered vascular grafts, which can fit patient-specific dimensions, optimize hemodynamics, exhibit antithrombotic and anti-infective properties, and accommodate growth.
Methods:We procured cardiac magnetic resonance imaging with 4-dimensional flow for native porcine anatomy (n = 10), from which we designed tissue-engineered vascular grafts for the distal aortic arch, 4 weeks before surgery. An optimal shape of the curved vascular graft was designed using computer-aided design informed by computational fluid dynamics analysis. Grafts were manufactured and implanted into the distal aortic arch of porcine models, and postoperative cardiac magnetic resonance imaging data were collected. Pre- and postimplant hemodynamic data and histology were analyzed.
Results:Postoperative magnetic resonance imaging of all pigs with 1:1 ratio of polycaprolactone and poly-L-lactide-co-ε-caprolactone demonstrated no specific dilatation or stenosis of the graft, revealing a positive growth trend in the graft area from the day after surgery to 3 months later, with maintaining a similar shape. The peak wall shear stress of the polycaprolactone/poly-L-lactide-co-ε-caprolactone graft portion did not change significantly between the day after surgery and 3 months later. Immunohistochemistry showed endothelization and smooth muscle layer formation without calcification of the polycaprolactone/poly-L-lactide-co-ε-caprolactone graft.
Conclusions:Our patient-specific polycaprolactone/poly-L-lactide-co-ε-caprolactone tissue-engineered vascular grafts demonstrated optimal anatomical fit maintaining ideal hemodynamics and neotissue formation in a porcine model. This study provides a proof of concept of patient-specific tissue-engineered vascular grafts for aortic arch reconstruction.
Affiliations
Advocate Children's Hospital, Oak Lawn