Reconstruction of pulmonary artery with porcine small intestinal submucosa in a lamb surgical model: Viability and growth potential

Boni, Lorenzo; Chalajour, Fariba; Sasaki, Takashi; Snyder, Radhika; Boyd, W. Douglas; Riemer, R. Kirk; Reddy, V. Mohan

doi:10.1016/j.jtcvs.2012.07.024

Cited by 27 publications

(19 citation statements)

References 26 publications

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“…In previous studies, SIS was used as a replacement for large diameter vena cava grafts in pigs [24] and as vascular patches supporting host cell infiltration [25, 26], but its performance as a small diameter arterial replacement graft has been inadequate [27], possibly due to lack of a functional endothelium. Our study showed that unlike vascular grafts based on decellularized arteries [7] or decellularized polymer based TEVs [5, 6], the endothelialized SIS-Fibrin scaffold yielded high patency rates (100%) and enabled significant repopulation by incoming host cells throughout the graft, even in the absence of donor SMCs.…”

Section: Discussionmentioning

confidence: 99%

Arterial grafts exhibiting unprecedented cellular infiltration and remodeling in vivo: The role of cells in the vascular wall

et al. 2015

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Objective To engineer and implant vascular grafts in the arterial circulation of a pre-clinical animal model and assess the role of donor medial cells in graft remodeling and function. Approach and results Vascular grafts were engineered using Small Intestinal Submucosa (SIS)-fibrin hybrid scaffold and implanted interpositionally into the arterial circulation of an ovine model. We sought to demonstrate implantability of SIS-Fibrin based grafts; examine the remodeling; and determine whether the presence of vascular cells in the medial wall was necessary for cellular infiltration from the host and successful remodeling of the implants. We observed no occlusions or anastomotic complications in 18 animals that received these grafts. Notably, the grafts exhibited unprecedented levels of host cell infiltration that was not limited to the anastomotic sites but occurred through the lumen as well as the extramural side, leading to uniform cell distribution. Incoming cells remodeled the extracellular matrix and matured into functional smooth muscle cells as evidenced by expression of myogenic markers and development of vascular reactivity. Interestingly, tracking the donor cells revealed that their presence was beneficial but not necessary for successful grafting. Indeed, the proliferation rate and number of donor cells decreased over time as the vascular wall was dominated by host cells leading to significant remodeling and development of contractile function. Conclusions These results demonstrate that SIS-Fibrin grafts can be successfully implanted into the arterial circulation of a clinically relevant animal model, improve our understanding of vascular graft remodeling and raise the possibility of engineering mural cell-free arterial grafts.

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Section: Discussionmentioning

confidence: 99%

Arterial grafts exhibiting unprecedented cellular infiltration and remodeling in vivo: The role of cells in the vascular wall

et al. 2015

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“…It has been successfully introduced in surgery as a new substitute material for different applications in order to provide biocompatibility and potential remodeling or even tissue regeneration . The tissue remodeling and regeneration of this material has been demonstrated in preclinical experiments . Histological examination of explanted SIS‐ECM patches used in humans showed resorption and no calcification of the material as well as replacement with organized collagen, neovascularization, and reendothelization.…”

Section: Characteristics (Advantages and Disadvantages) Of Different mentioning

confidence: 88%

“…3 The tissue remodeling and regeneration of this material has been demonstrated in preclinical experiments. [6][7][8][9][10] Histological examination of explanted SIS-ECM patches used in humans showed resorption and no calcification of the material as well as replacement with organized collagen, neovascularization, and reendothelization. Table 2 shows the list of currently available SIS-ECM-derived products on the market with their clinical application.…”

mentioning

confidence: 96%

“…5 The most widely studied ECM material is that derived from the porcine small intestinal submucosa (SIS). [6][7][8][9][10] It has been successfully introduced in surgery as a new substitute material for different applications in order to provide biocompatibility and potential remodeling or even tissue regeneration. 3 The tissue remodeling and regeneration of this material has been demonstrated in preclinical experiments.…”

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confidence: 99%

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The Use of Extracellular Matrix Patches in Cardiac Surgery

et al. 2014

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“…Follow-on studies in the early 1990s utilized similar models to examine porcine (xenogeneic) SIS [9,10]. Over the last decade, porcine SIS and the newer SIS-ECM have been used in a variety of cardiovascular applications in a number of different animals, including pigs [8,11,21,23], sheep [12][13][14]24] and cows [22], and for a variety of purposes such as arterial or venous grafting [9][10][11][14][15][16][17], valve replacement [12,21,[23][24][25][26] and myocardial repair or patching [8,22]. Although the number of animals used in these studies was often small, these were important studies that together laid the ground for the clinical studies using SIS-ECM.…”

Section: Preclinical Studies Of Porcine Small Intestinal Submucosa Anmentioning

confidence: 99%

Small intestinal submucosa extracellular matrix (CorMatrix®) in cardiovascular surgery: a systematic review

Nezhad

Poncelet

Kerchove

et al. 2016

Interact CardioVasc Thorac Surg

114

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Extracellular matrix (ECM) derived from small intestinal submucosa (SIS) is widely used in clinical applications as a scaffold for tissue repair. Recently, CorMatrix® porcine SIS-ECM (CorMatrix Cardiovascular, Inc., Roswell, GA, USA) has gained popularity for 'next-generation' cardiovascular tissue engineering due to its ease of use, remodelling properties, lack of immunogenicity, absorbability and potential to promote native tissue growth. Here, we provide an overview of the biology of porcine SIS-ECM and systematically review the preclinical and clinical literature on its use in cardiovascular surgery. CorMatrix® has been used in a variety of cardiovascular surgical applications, and since it is the most widely used SIS-ECM, this material is the focus of this review. Since CorMatrix® is a relatively new product for cardiovascular surgery, some clinical and preclinical studies published lack systematic reporting of functional and pathological findings in sufficient numbers of subjects. There are also emerging reports to suggest that, contrary to expectations, an undesirable inflammatory response may occur in CorMatrix® implants in humans and longer-term outcomes at particular sites, such as the heart valves, may be suboptimal. Large-scale clinical studies are needed driven by robust protocols that aim to quantify the pathological process of tissue repair.

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Reconstruction of pulmonary artery with porcine small intestinal submucosa in a lamb surgical model: Viability and growth potential

Abstract: Our data confirmed that remodeling and growth potential of the small intestine submucosal biomaterial are time dependent. Additional experiments are required to investigate the stability of the patch material over a longer period.

Cited by 27 publications

References 26 publications

Arterial grafts exhibiting unprecedented cellular infiltration and remodeling in vivo: The role of cells in the vascular wall

Arterial grafts exhibiting unprecedented cellular infiltration and remodeling in vivo: The role of cells in the vascular wall

The Use of Extracellular Matrix Patches in Cardiac Surgery

Small intestinal submucosa extracellular matrix (CorMatrix®) in cardiovascular surgery: a systematic review

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