A fully biodegradable polydioxanone occluder for ventricle septal defect closure

Li, Zefu; Kong, Pengxu; Liu, Xiang; Shi, Feng; Ouyang, Wenbin; Wang, Shouzheng; Hu, Xiaopeng; Xie, Yong; Zhang, Fengwen; Zhang, Yuxin; Gao, Rui; Pan, Xiangbin

doi:10.1016/j.bioactmat.2022.12.018

Cited by 4 publications

(15 citation statements)

References 34 publications

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“…This requires additional shapeline assistance. 70,71 In summary, PDO seems to be a suitable material among existing materials for cardiac occluder skeletons in terms of various performance requirements. With ongoing research, PDO may play a crucial role in the development of new bioabsorbable cardiac occluders.…”

Section: Polydioxanonementioning

confidence: 99%

“…Therefore, a shape line made of nylon or PDO monofilament that passes through the double-sided discs is introduced to assist in occluder shaping. 70,71 Two teams implanted the occluders into 18 and 14 VSD dogs under transthoracic echocardiography guidance and followed up for 24 months. Three months after implantation, the occluder surface was completely endothelialized.…”

Section: Improved Amplazter Occludermentioning

confidence: 99%

“…122,123 Compared with other biodegradable polymers, like PGA and PLA, PDO produces less acidic products, elicits weaker inflammatory reactions, and has better flexibility and tensile strength. 70,124,125 Given the persistent good mechanical properties, machinability, non-antigenity, low inflammatory reaction, and predictable degradation rate, it has been widely used in various medical applications, such as sutures, drug carriers, airway stents, biliary stents, tissue engineering scaffolds. 51,124,[126][127][128][129][130][131] Both the Pansy occluder and Memsorb occluder used PDO as the skeleton material, and clinical trial results were satisfactory.…”

Section: Polydioxanonementioning

confidence: 99%

“…51,124,[126][127][128][129][130][131] Both the Pansy occluder and Memsorb occluder used PDO as the skeleton material, and clinical trial results were satisfactory. 51,52,[68][69][70][71][72] The complete degradation took around 6-24 months, and the loss of support strength was slow during degradation, hence, it could provide good support for 5-6 weeks. [68][69][70][71][72] Even 6 weeks after implantation, the strength remained at around 50% of its original level.…”

Section: Polydioxanonementioning

confidence: 99%

“…51,52,[68][69][70][71][72] The complete degradation took around 6-24 months, and the loss of support strength was slow during degradation, hence, it could provide good support for 5-6 weeks. [68][69][70][71][72] Even 6 weeks after implantation, the strength remained at around 50% of its original level. 68,69,72 Animal experiments have also shown that PDO was able to accelerate endothelialization, which was significantly faster than the degradation rate.…”

Section: Polydioxanonementioning

confidence: 99%

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Progress of biodegradable polymer application in cardiac occluders

Xu,

Fa,

Yang

et al. 2023

J Biomed Mater Res

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Cardiac septal defect is the most prevalent congenital heart disease and is typically treated with open‐heart surgery under cardiopulmonary bypass. Since the 1990s, with the advancement of interventional techniques and minimally invasive transthoracic closure techniques, cardiac occluder implantation represented by the Amplazter products has been the preferred treatment option. Currently, most occlusion devices used in clinical settings are primarily composed of Nitinol as the skeleton. Nevertheless, long‐term follow‐up studies have revealed various complications related to metal skeletons, including hemolysis, thrombus, metal allergy, cardiac erosion, and even severe atrioventricular block. Thus, occlusion devices made of biodegradable materials have become the focus of research. Over the past two decades, several bioabsorbable cardiac occluders for ventricular septal defect and atrial septal defect have been designed and trialed on animals or humans. This review summarizes the research progress of bioabsorbable cardiac occluders, the advantages and disadvantages of different biodegradable polymers used to fabricate occluders, and discusses future research directions concerning the structures and materials of bioabsorbable cardiac occluders.

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Section: Polydioxanonementioning

confidence: 99%

Section: Improved Amplazter Occludermentioning

confidence: 99%

Section: Polydioxanonementioning

confidence: 99%

Section: Polydioxanonementioning

confidence: 99%

Section: Polydioxanonementioning

confidence: 99%

See 3 more Smart Citations

Progress of biodegradable polymer application in cardiac occluders

Xu,

Fa,

Yang

et al. 2023

J Biomed Mater Res

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Biodegradable Cardiac Occluder with Surface Modification by Gelatin–Peptide Conjugate to Promote Endogenous Tissue Regeneration

Kong,

Liu,

et al. 2023

Advanced Science

Self Cite

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Transcatheter intervention has been the preferred treatment for congenital structural heart diseases by implanting occluders into the heart defect site through minimally invasive access. Biodegradable polymers provide a promising alternative for cardiovascular implants by conferring therapeutic function and eliminating long‐term complications, but inducing in situ cardiac tissue regeneration remains a substantial clinical challenge. PGAG (polydioxanone/poly (l‐lactic acid)–gelatin–A5G81) occluders are prepared by covalently conjugating biomolecules composed of gelatin and layer adhesive protein‐derived peptides (A5G81) to the surface of polydioxanone and poly (l‐lactic acid) fibers. The polymer microfiber–biomacromolecule–peptide frame with biophysical and biochemical cues could orchestrate the biomaterial–host cell interactions, by recruiting endogenous endothelial cells, promoting their adhesion and proliferation, and polarizing immune cells into anti‐inflammatory phenotypes and augmenting the release of reparative cytokines. In a porcine atrial septal defect (ASD) model, PGAG occluders promote in situ tissue regeneration by accelerating surface endothelialization and regulating immune response, which mitigate inflammation and fibrosis formation, and facilitate the fusion of occluder with surrounding heart tissue. Collectively, this work highlights the modulation of cell–biomaterial interactions for tissue regeneration in cardiac defect models, ensuring endothelialization and extracellular matrix remodeling on polymeric scaffolds. Bioinspired cell–material interface offers a highly efficient and generalized approach for constructing bioactive coatings on medical devices.

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Recent Development of Biodegradable Occlusion Devices for Intra-Atrial Shunts

Li,

Chen,

Xie

et al. 2024

Rev. Cardiovasc. Med.

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Atrial septal defect (ASD) is the third most common type of structural congenital heart defect. Patent foramen ovale (PFO) is an anatomical anomaly in up to 25% of the general population. With the innovation of occlusion devices and improvement of transcatheter techniques, percutaneous closure has become a first-line therapeutic alternative for treatment of ASD and PFO. During the past few decades, the development of biodegradable occlusion devices has become a promising direction for transcatheter closure of ASD/PFO due to their biodegradability and improved biocompatibility. The purpose of this review is to comprehensively summarize biodegradable ASD/PFO occlusion devices, regarding device design, materials, biodegradability, and evaluation of animal or clinical experiments (if available). The current challenges and the research direction for the development of biodegradable occluders for congenital heart defects are also discussed.

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A fully biodegradable polydioxanone occluder for ventricle septal defect closure

Cited by 4 publications

References 34 publications

Progress of biodegradable polymer application in cardiac occluders

Progress of biodegradable polymer application in cardiac occluders

Biodegradable Cardiac Occluder with Surface Modification by Gelatin–Peptide Conjugate to Promote Endogenous Tissue Regeneration

Recent Development of Biodegradable Occlusion Devices for Intra-Atrial Shunts

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