Durability of down-sized homografts for the reconstruction of the right ventricular outflow tract

Cleuziou, Julie; Vitanova, Keti; Kašnar-Šamprec, Jelena; Hörer, Jürgen; Lange, Rüdiger; Schreiber, Christian

doi:10.1093/ejcts/ezv418

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…Results of cell activity test on unmodified ePTFE, (HEP/COL)5 modified ePTFE, REDV-(HEP/COL)5 modified ePTFE, and REVD-(HEP/ COL)5 modified ePTFE(6,24, 48, and 72 h).…”

mentioning

confidence: 99%

“…Even homografts, which are widely used in western clinical centers but cannot be obtained in China due to legal problems and regional reasons, show a decay rate of 25% in 5 years and 45% in 10 years . Moreover, age is an important factor for biological valve failure . In short, the long‐term availability and durability of these valvar materials are not satisfactory, especially for younger children.…”

mentioning

confidence: 99%

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Application of Heparin/Collagen‐REDV Selective Active Interface on ePTFE Films to Enhance Endothelialization and Anticoagulation

Shan

Jia

et al. 2018

Artificial Organs

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Expanded polytetrafluoroethylene (ePTFE) prosthetic valves have been widely used in clinical applications in Asian countries. However, these valves still have limits with regard to thrombosis, neointimal hyperplasia, restenosis, and valvar vegetation. The achievement of in situ endothelialization on implant materials is a promising way to overcome those limits. Here, heparin/collagen multilayers were fabricated on ePTFE films via a layer-by-layer (LBL) self-assembly technique, and then, the endothelial cell (EC) adhesive peptide sequence Arg-Glu-Asp-Val (REDV) was immobilized on the multilayers. After modification with the heparin/collagen multilayers with or without REDV peptide, less platelet activation and aggregation were observed, the blood coagulation time was increased, and the hemolysis rate was decreased compared to that on pristine ePTFE films. The REDV-functionalized ePTFE films positively impacted early EC adhesion, later cell proliferation and cell activity. The EC barrier was confirmed to be successfully achieved on the functionalized ePTFE film surface in vitro. The successful assembly of the REDV-functionalized heparin/collagen multilayer on ePTFE films improved the blood compatibility, anticoagulant properties, and cell compatibility of the films in vitro, and thus, represents a candidate approach for applications requiring quick in situ endothelialization in vivo.

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“…Results of cell activity test on unmodified ePTFE, (HEP/COL)5 modified ePTFE, REDV-(HEP/COL)5 modified ePTFE, and REVD-(HEP/ COL)5 modified ePTFE(6,24, 48, and 72 h).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Application of Heparin/Collagen‐REDV Selective Active Interface on ePTFE Films to Enhance Endothelialization and Anticoagulation

Shan

Jia

et al. 2018

Artificial Organs

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“…The down-sized technique was first described by Michler et al in 1994, obtaining a bicuspid valved conduit by removing one of the three valve leaflets and the attached wall ( 8 ). The largest study cohort of down-sized homograft conduits came from the German Heart Centre, Munich ( 9 ). Eighty-two patients receiving a down-sized homograft were compared to 70 patients receiving normal small-sized homograft.…”

Section: Clinical Outcomes Of Available Conduitsmentioning

confidence: 99%

“…One way to help deal with the shortage of small-sized conduits is the down-sized technique (8). We were pleased to find that this technique does not affect the the function and durability of the conduits (9,10). There is no doubt that the bovine jugular vein conduit (BJVC), usually known as Contegra R conduit (Medtronic Inc., Minneapolis, Minnesota, USA), has achieved great success.…”

Section: Introductionmentioning

confidence: 99%

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

et al. 2021

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Purpose of Review: Right ventricular outflow tract (RVOT) reconstruction remains a challenge due to the lack of an ideal conduit. Data and experience are accumulating with each passing day. Therefore, it is necessary to review this topic from time to time. This is a 2021 update review focused on the history, evolution, and current situation of small-sized conduits (≤ 16 mm) for RVOT reconstruction in infants and young children.Recent Findings: Currently, the available small-sized (≤16 mm) conduits can meet most clinical needs. Homograft is still a reliable choice for infants and young children validated by a half-century clinical experience. As an alternative material, bovine jugular vein conduit (BJVC) has at least comparable durability with that of homograft. The performance of expanded polytetrafluoroethylene (ePTFE) is amazing in RVOT position according to limited published data. The past century has witnessed much progress in the materials for RVOT reconstruction. However, lack of growth potential is the dilemma for small-sized conduits. Tissue-engineering based on cell-free scaffolds is the most promising technology to obtain the ideal conduit.Summary: No conduit has proved to have lifelong durability in RVOT position. We are far from the ideal, but we are not in a state of emergency. In-depth clinical research as well as innovation in material science are needed to help improve the durability of the conduits used in infants and young children.

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“…This is the reason, why some surgeons started to "bicuspidalize" or "downsize" homografts, removing a cusp and sewing it back together to have a smaller-sized bicuspid homograft (Figures 1,2). This surgical method arose out of the need for small-sized homografts and is widely used in centres with access to homografts (4,5).…”

mentioning

confidence: 99%

Durability of down-sized homografts for the reconstruction of the right ventricular outflow tract

Cited by 9 publications

References 21 publications

Application of Heparin/Collagen‐REDV Selective Active Interface on ePTFE Films to Enhance Endothelialization and Anticoagulation

Application of Heparin/Collagen‐REDV Selective Active Interface on ePTFE Films to Enhance Endothelialization and Anticoagulation

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Is there any progress in the search for the ideal conduit for reconstruction of the right ventricular outflow tract in young children?

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