Augmentation of the Lesser Curvature With an Autologous Vascular Patch in Complex Aortic Coarctation and Interruption

Lee, Heemoon; Yang, Ji-Hyuk; Jun, Tae-Gook; Cho, Yang Hyun; Kang, I-Seok; Huh, June; Song, Jinyoung

doi:10.1016/j.athoracsur.2016.01.017

Cited by 25 publications

(14 citation statements)

References 28 publications

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“…Tomita et al [41] showed that in mice, both the aortic arch angle and cross-sectional area of the aortic arch correlated positively with the area of the plaque. Enhanced clinical outcomes were observed for an autologous vascular graft resembling the curvature of the aortic arch [42]. The crescent graft herein was proposed to better mimic the native arch shape (i.e., a smaller aortic arch angle), tapered cross-sectional area, and smooth curvature compared to the half-moon graft (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Hemodynamics and Wall Mechanics after Surgical Repair of Aortic Arch: Implication for Better Clinical Decisions

Abdullah

Lin

et al. 2019

Applied Sciences

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Graft repair of aortic coarctation is commonly used to mimic the physiological aortic arch shape and function. Various graft materials and shapes have been adopted for the surgery. The goal of this work is to quantitatively assess the impact of graft materials and shapes in the hemodynamics and wall mechanics of the restored aortic arch and its correlation with clinical outcomes. A three-dimensional aortic arch model was reconstructed from magnetic resonance images. The fluid–structure interaction (FSI) analysis was performed to characterize the hemodynamics and solid wall mechanics of the repaired aortic arch. Two graft shapes (i.e., a half-moon shape and a crescent one) were considered. Material choices of the aortic arch repair included three commonly used graft materials (i.e., polytetrafluoroethylene (PTFE) synthetic graft, CorMatrix extracellular matrix, and pulmonary homograft) as well as one native tissue serving as a control. The pathological hemodynamic parameters, in terms of the percentage area of low wall shear stress (WSS), high oscillatory shear index (OSI), and high relative residence time (RRT), were quantified to be associated with potential clinical outcomes. Results have shown that the peak von Mises stress for the aortic arch repaired by the crescent graft was 76% less than that of the half-moon graft. Flow disturbance and recirculation were also minimized with the crescent graft. Moreover, pathological hemodynamic parameters were significantly reduced with the crescent graft. The graft material mismatch with the surrounding tissue aggregated the stress concentration on the aortic wall, but had minimal impact on flow dynamics. The present work demonstrated the role and importance of the graft geometry and materials on hemodynamics and wall mechanics, which could guide optimal graft decisions towards better clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Hemodynamics and Wall Mechanics after Surgical Repair of Aortic Arch: Implication for Better Clinical Decisions

Abdullah

Lin

et al. 2019

Applied Sciences

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“…Тактика хірургічного лікування багато в чому залежить від протяжності гіпоплазії, а особливо від наявності супутніх ВВС. Нерідко анатомія дуги аорти і брахіоцефальних судин не дозволяє виконати адекватну мобілізацію судин і корекцію вади з лівобічного доступу, оскільки [2,3,5]. Випадки наростання градієнта тиску в післяопераційному періоді і повторні втручан-ня в досліджуваній групі були пов'язані з недостатнім видаленням дуктальних тканин у місці пластики дуги аорти.…”

Section: таблиця 1 перелік супутніх ввс поєднаних з гіпоплазією дугиunclassified

Aortic Arch Reconstruction in Infants Using Autologus Pericardium

Truba

Dovhaliuk²,

Dziuryi

et al. 2020

ujcvs

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Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. This defect occurs either as an isolated condition or combined with other congenital heart defects. The materials used to enlarge aorta for successful repair and prevention of postoperative complications range from the patient’s own aortic tissue (in most cases) to other materials (autopericardium, xenopericardium, pulmonary artery tissues, synthetic patches). An autologous pericardial patch is the most common, available and cheap option. The purpose of this work is toanalyze immediate and long-term results of our experience using autologous pericardium to reconstruct the aortic arch. Materials and methods. From 2011 to 2019 at the National M.M. Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and Ukrainian Children’s Cardiac Center 16 infants underwent aortic arch repair using autologous pericardial patch. The group included 6 (37.5%) male and 10 (62.5%) female patients. The mean age of the patients was 1.3 ± 0.9 months (from 0.06 to 4.5 months), the average body weight was 3.8 ± 1.6 kg (from 2.2 to 8.7 kg). The average body surface area was 0.24 ± 0.05 m?. Antegrade selective cerebral perfusion was performed in all the patients during the aortic arch reconstruction. Results. Hospital mortality was 6.2% (n = 1). The cause of death was not related to the reconstruction technique. The average duration of cardiopulmonary bypass was 142.5 ± 38.5 minutes, the aortic cross-clamp time was 76.9 ± 33.7 minutes, and the time of selective cerebral perfusion was 50.4 ± 25.4 minutes. Six patients (37.5%) in the early postoperative period had delayed sternal closure. According to echocardiographic data at discharge, the average pressure gradient at the site of aortic arch reconstruction was 15 ± 5.5 mm Hg, the left ventricular ejection fraction was 65.9 ± 5.9%. The mean follow-up period ranged from one month to 6.1 years (mean 2.8 ± 2.3 years). There were no deaths in the long-term period. Four (25%) patients developed aortic arch restenosis in the postoperative period. One patient presented with an aortic arch aneurysm 1 month after the initial operation. There were no cases of compression of the trachea, main bronchi, neurological complications in the follow-up period. Conclusions. The use of autologous pericardium in aortic arch reconstruction is an effective and safe procedure for infants with good immediate and long-term results. The study showed that autologous pericardium may be an acceptable alternative to reconstruct the aortic arch. A large percentage of reinterventions encourages more thorough removal of ductal tissues and determining the size of the autopericardial patch.

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“…Vascular patches have been extensively used to treat damaged or diseased blood vessels caused by cardiovascular diseases, a class of life-threatening diseases afflicting more than 10 million people worldwide. 1–6 For a damaged or diseased blood vessel, its innermost layer (i.e. endothelium) cannot function properly, which can lead to blood clotting, vessel blockage, and even death.…”

Section: Introductionmentioning

confidence: 99%

Sodium triphosphate–capped silver nanoparticles on a decellularized scaffold-based polyurethane vascular patch for bacterial infection inhibition and rapid endothelialization

Liu

Hong

et al. 2019

Journal of Bioactive and Compatible Polymers

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With increasing incidence rate of cardiovascular diseases and implant-related infections, there is growing demand for vascular patches that can promote endothelialization and resist bacterial infection. In this work, we immobilized sodium triphosphate–capped silver nanoparticles onto a polyurethane film to obtain a composite film and evaluated its in vitro biocompatibility. Subsequently, we anchored sodium triphosphate–capped silver nanoparticles onto a polyurethane-coated decellularized scaffold to prepare a vascular patch and investigated its in vivo performance in a mouse model. The prepared vascular patch demonstrated excellent biocompatibility and potent antibacterial activity against Escherichia coli and Staphylococcus aureus. It still maintained the surgical artery patency at 30 days after implantation. At the same time, the endothelialization at the surgical site was achieved, showing its ability to facilitate endothelialization. Therefore, it may be a promising candidate for combating bacterial infection and treating diseased blood vessels.

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Augmentation of the Lesser Curvature With an Autologous Vascular Patch in Complex Aortic Coarctation and Interruption

Cited by 25 publications

References 28 publications

Hemodynamics and Wall Mechanics after Surgical Repair of Aortic Arch: Implication for Better Clinical Decisions

Hemodynamics and Wall Mechanics after Surgical Repair of Aortic Arch: Implication for Better Clinical Decisions

Aortic Arch Reconstruction in Infants Using Autologus Pericardium

Sodium triphosphate–capped silver nanoparticles on a decellularized scaffold-based polyurethane vascular patch for bacterial infection inhibition and rapid endothelialization

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