Although the efficacy of external stents for vein grafts in coronary artery bypass grafting has been recognized, the ideal diameter and material of the stent remain controversial. We created a new external stent made of soft polyester mesh and performed an animal experiment using canines. Bilateral saphenous vein grafts were interposed in the bilateral common carotid artery of 10 beagles. The grafts in the left carotid artery were designated as the control group, and those in the right rolled by a soft polyester mesh external stent were designated as mesh group. Two of the 10 animals were sacrificed due to severe wound infection. The other eight were observed by echography for 6 months, and then grafts were extracted and thickness of the neointima of the grafts was measured. The control group showed 146% ± 26% postoperative enlargement of the internal diameter of the vein grafts after 6 months, whereas the mesh group showed only 115% ± 15% after the same duration (P = 0.0003). The median thickness of the neointima in the mesh group (170 µm [range: 150–190]) was significantly thinner than that in the control group (260 µm [range: 220–310], P < 0.0001). Some degree of correlation between the thickness of neointima and proportion of enlargement was noted (r = 0.518, P = 0.0024). A soft polyester mesh external stent for vein grafts successfully suppressed the enlargement of the vein grafts and thickness of the neointima after 6 months.

Background Glutaraldehyde (GA)-fixed autologous tissues, including the pericardium, are widely used as patches and valve substitutes in cardiovascular surgery. However, the treatment causes tissue calcification. No rapid anticalcification treatment method has been established for use during surgery. Here, we aimed to establish a rapid method for anticalcification treatment. Methods Thoracic aorta tissues were first fixed with GA for 3 min, and post-treated with ethanol for 0, 10, 20, and 30 min representing groups 2, 3, 4, and 5, respectively; untreated tissues served as the control (group 1). The treated tissues were subdermally implanted into 3-week-old male Wistar rats for 28 days. The calcification level in each explant was evaluated semiquantitatively by annotating and measuring the area using virtual slides; the data were statistically analyzed. Results Semiquantitative calcification analysis revealed that the calcification of implants from the untreated group (group 1; P = 0.0014) and groups 4 (P = 0.0014) and 5 (P = 0.0031) was significantly lower than that from group 2. Meanwhile, implants from group 3 showed a tendency towards decreased calcification, although this was not significant (P = 0.0503). Conclusions A rapid ethanol treatment might prevent the calcification of GA-fixed tissues in a rat model of subdermal implantation. This method may facilitate an effective and rapid anticalcification treatment of autologous tissues for use during cardiovascular surgery.

Background Glutaraldehyde (GA)-fixed autologous tissues, including the pericardium, are widely used as patches and valve substitutes in cardiovascular surgery. However, GA treatment causes tissue calcification. No rapid anticalcification method has been established for use during surgery. Here, we aimed to establish a rapid anticalcification method using ethanol, as has already been demonstrated for bioprosthetic valves. Methods Thoracic aorta tissues were first fixed with GA for 3 min and then treated with ethanol for 0 (group 2), 10 (group 3), 20 (group 4), and 30 (group 5) min; untreated tissues (group 1) served as the control. The treated tissues were subdermally implanted into 3-week-old male Wistar rats and kept in place for 28 days. The calcification in each explant was semiquantitatively evaluated by annotating and measuring the area using virtual slides, and the data obtained were statistically analyzed. Results Semiquantitative analysis revealed that calcification of the implants from the untreated group (group 1; P = 0.0014) and groups 4 (P = 0.0014) and 5 (P = 0.0031) was significantly lower than that of implants from group 2. Moreover, implants from group 3 showed a tendency toward decreased calcification, although it was not significant (P = 0.0503). Conclusions A rapid ethanol treatment prevents calcification of GA-fixed tissues in a rat model of subdermal implantation. This method may facilitate effective and rapid anticalcification of autologous tissues for use during cardiovascular surgery.

A 76-year-old man with a complaint of dyspnea was diagnosed with acute severe mitral regurgitation due to ruptured chordae tendineae. For improvement of pulmonary congestion, we introduced IMPELLA 5.0 ® and extra-corporeal membrane oxygenation before valve surgery. After two-days IMPELLA 5.0 ® support, mitral valve replacement surgery with a bioprosthetic valve was performed and IMPELLA 5.0 ® was withdrawn. We report a successful case of a bridge to surgery using IMPELLA 5.0 ® with mitral valve regurgitation accompanied by acute left heart failure with severe respiratory failure.