Mechano-biological adaptation of the pulmonary artery exposed to systemic conditions

Vanderveken, Emma; Vastmans, Julie; Claus, Piet; Verbeken, Eric; Fehervary, Heleen; Hoof, Lucas Van; Vandendriessche, Katrien; Verbrugghe, Peter; Famaey, Nele; Rega, Filip

doi:10.1038/s41598-020-59554-7

Cited by 19 publications

(41 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Corresponding to ref. 32, the stiffness moduli at different strain levels i were calculated as the slope of the stress–strain curves at those different strains i . The slopes were determined after linearly interpolating the experimental data points in a range between i − 0.5% and i + 0.5%, with i being a strain of 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10% (see Supplementary material for details, Appendix S5).…”

Section: Methodsmentioning

confidence: 99%

Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham‐controlled trial

Mackova

Mazzer

Cunha

et al. 2020

BJOG

Self Cite

View full text Add to dashboard Cite

Objective To describe effects of non‐ablative erbium‐doped:yttrium‐aluminium‐garnet (Er:YAG) laser on vaginal atrophy induced by iatrogenic menopause in the ewe. Design Animal experimental, randomised, sham and estrogen‐treatment controlled study with blinding for primary outcome. Setting KU Leuven, Belgium. Sample Twenty‐four ewes. Methods Menopause was surgically induced, after which the ewes were randomised to three groups receiving vaginal Er:YAG laser application three times, with a 1‐month interval; three sham manipulations with a 1‐month interval; or estrogen replacement and sham manipulations. At given intervals, ewes were clinically examined and vaginal wall biopsies were taken. Vaginal compliance was determined by passive biomechanical testing from explants taken at autopsy. Main outcome measures Vaginal epithelial thickness (primary), composition of the lamina propria (collagen, elastin, glycogen and vessel content), vaginal compliance, clinical signs. Results Animals exposed to Er:YAG laser application and sham manipulation, but not to estrogens, displayed a significant and comparable increase in vaginal epithelial thickness between baseline and 7 days after the third application (69% and 67%, respectively, both P < 0.0008). In laser‐treated ewes, temporary vaginal discharge and limited thermal injury were observed. Estrogen‐substituted ewes displayed a more prominent increase in epithelial thickness (202%; P < 0.0001) and higher vaginal compliance (P < 0.05). None of the interventions induced changes in the lamina propria. Conclusions Vaginal Er:YAG laser has comparable effect to sham manipulation in menopausal ewes. Tweetable abstract Vaginal Er:YAG laser has comparable effect to sham manipulation in menopausal ewes #LASER #GSM #RCT.

show abstract

Section: Methodsmentioning

confidence: 99%

Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham‐controlled trial

Mackova

Mazzer

Cunha

et al. 2020

BJOG

Self Cite

View full text Add to dashboard Cite

show abstract

“…An overview of previous animal models studying the Ross procedure is shown in Table 1. To evaluate the isolated effect of systemic pressures on pulmonary arterial tissue, the authors have previously implanted a segment of the main pulmonary artery in the descending aorta of sheep, with and without external support by a porous mesh (28). In a similar animal model, Nappi et al investigated the effect of a composite, partially resorbable external support on autograft dilatation and histological adaptation, with promising results (21)(22)(23)(24).…”

Section: Existing Animal Models Of the Ross Proceduresmentioning

confidence: 99%

Back to the root: a large animal model of the Ross procedure

Hoof¹,

Claus²,

Jones³

et al. 2021

Ann Cardiothorac Surg

Self Cite

View full text Add to dashboard Cite

The excellent clinical outcome of the Ross procedure and previous histological studies suggest that the pulmonary autograft has the potential to offer young patients a permanent solution to aortic valve disease.We aim to study the early mechanobiological adaptation of the autograft. To this end, we have reviewed relevant existing animal models, including the canine models which enabled Donald N Ross to perform the first Ross procedure in a patient in 1967. Two research groups recently evaluated the isolated effect of systemic pressures on pulmonary arterial tissue in an ovine model of a pulmonary artery interposition graft in the descending aorta. While this model is ideal to study the artery's biological response and the effect of external support, it does not recreate the complex environment of the aortic root. The freestanding Ross procedure has been performed in pigs and sheep before. These studies offered valuable insights into leaflet growth and histological remodeling, yet may be less relevant to adults undergoing the Ross procedure, as pronounced autograft dilatation was achieved by using small, rapidly growing animals. Therefore, a large animal model remains needed to determine the ideal conditions and surgical technique to ensure longterm autograft remodeling and valve function. We set out to develop an ovine model of the Ross procedure performed as a freestanding root replacement, acknowledging that the sheep's specific anatomy and the setting of an animal laboratory would mandate several modifications in surgical strategy. This article describes the development, surgical technique and early outcomes of our animal model while highlighting opportunities for further research.

show abstract

“…[22,23] The absence of type A dissections in our study is consistent with previous reports showing that PEARS stabilises aortic dimensions while becoming incorporated histologically and reducing wall stress. [5,[8][9][10][11][12][13] It is unknown how many dissections were effectively prevented in our study as it is currently not possible to predict who would have dissected without surgery. [24] Because many patients were operated at an earlier disease stage than at which root replacement is typically performed, and because follow-up is short for many patients, long-term follow-up is needed to monitor the occurrence of aortic events.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] PEARS has the potential to eliminate the risk of aortic dissection by augmenting the mechanical properties of a compromised aortic wall while reducing circumferential and longitudinal wall stress. [5,[8][9][10][11][12][13] To confirm the ability of PEARS to prevent aortic dissection, the long-term incidence of aortic and device-related events must be followed. The aim of this study is to report clinical outcomes for the first 200 primary aortic PEARS cases as the procedure was implemented at an increasing number of centres worldwide.…”

Section: Introductionmentioning

confidence: 99%

Personalised external aortic root support for elective treatment of aortic root dilation in 200 patients

Hoof

Rega

Golesworthy

et al. 2021

Heart

Self Cite

View full text Add to dashboard Cite

Background and objectivesIn personalised external aortic root support (PEARS), a custom-made, macroporous mesh is used to stabilise a dilated aortic root and prevent dissection, primarily in patients with genetically driven aortopathies. Data are needed on the safety and postoperative incidence of aortic events.MethodsWe present a multicentre cohort study evaluating the first 200 consecutive patients (median age 33 years) undergoing surgery with an intention to perform PEARS for aortic root dilatation in 23 centres between 2004 and 2019. Perioperative outcomes were collected prospectively while clinical follow-up was retrieved retrospectively. Median follow-up was 21.2 months.ResultsThe main indication was Marfan syndrome (73.5%) and the most frequent concomitant procedure was mitral valve repair (10%). An intervention for myocardial ischaemia or coronary injury was needed in 11 patients, 1 case resulting in perioperative death. No ascending aortic dissections were observed in 596 documented postoperative patient years. Late reoperation was performed in 3 patients for operator failure to achieve complete mesh coverage. Among patients with at least mild aortic regurgitation (AR) preoperatively, 68% had no or trivial AR at follow-up.ConclusionsThis study represents the clinical history of the first 200 patients to undergo PEARS. To date, aortic dissection has not been observed in the restrained part of the aorta, yet long-term follow-up is needed to confirm the potential of PEARS to prevent dissection. While operative mortality is low, the reported coronary complications reflect the learning curve of aortic root surgery in patients with connective tissue disease. PEARS may stabilise or reduce aortic regurgitation.

show abstract

Mechano-biological adaptation of the pulmonary artery exposed to systemic conditions

Cited by 19 publications

References 36 publications

Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham‐controlled trial

Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham‐controlled trial

Back to the root: a large animal model of the Ross procedure

Personalised external aortic root support for elective treatment of aortic root dilation in 200 patients

Contact Info

Product

Resources

About