Rapid prototyped sutureless anastomosis device from self‐curing silk bio‐ink

Abstract

Sutureless anastomosis devices are designed to reduce surgical time and difficulty, which may lead to quicker and less invasive cardiovascular anastomosis. The implant utilizes a barb-and-seat compression fitting composed of one male and two female components. The implant body is resorbable and capable of eluting heparin. Custom robotic deposition equipment was designed in order to fabricate the implants from a self-curing silk solution. Curing did not require deleterious processing steps but devices demonstrated high crush resistance, retention strength, and leak resistance. Radial crush resistance is in the range of metal vascular implants. Insertion force and retention strength of the anastomosis was dependent on fit sizing of the male and female components and subsequent vessel wall compression. Anastomotic burst strength was dependent on the amount of vessel wall compression, and capable of maintaining higher than physiological pressures. In initial screening using a porcine implant, the devices remained intact for 28 days (the length of study). Histological sections revealed cellular infiltration within the laminar structure of the male component, as well as at the interface between the male and female components. Initial degradation and absorption of the implant wall were observed. The speed per anastomosis using this new device was much faster than current systems, providing significant clinical improvement.

The History and Innovations of Blood Vessel Anastomosis

“…However, these devices are only designed to remain in place temporarily. In 2016, Jose and colleagues [ 78 ] published preliminary laboratory results on a prototype anastomotic device made of a silk:glycerol bio-ink solution deposited in 40 µm monolayers. They showed that their device is potentially resorbable in vivo, potentially allowing for long-term placement, and could be secured in under a minute [ 78 ].…”

Continuous Based Direct Ink Write for Tubular Cardiovascular Medical Devices

“…It is a biocompatible material that has good mechanical properties than can be tuned with the manufacturing process. In addition, other materials can be blended with the bioink to add characteristics that enhance the outcome of the solution, such as glycerol to add elasticity [ 71 ]. Additionally, it has shown good hemocompatibility, since it does not cause thrombogenic events and expresses solid cell colonization.…”

“…The assembled devices demonstrated a compressive strength comparable to self-expanding metal stents. Plus, it resisted pressure bursts greater than the physiological conditions [ 71 ]. The surgery time was reduced to approximately 1 min due to the new silk-based graft approach.…”

Organ Bioprinting: Are We There Yet?

“…[32] Therefore, achieving cell printing at high viscosity while maintaining acceptable cell viability during the printing process is one of the major challenges of extrusion bioprinting. [15,33] Extrusion bioprinting is also promising to deposit multicellular spheroids to greatly improve the efficiency of tissue fabrication.…”