Biodegradable materials for surgical management of infective endocarditis: new solution or a dead end street?

BMC Surgery

Afksendiyos Kalangos¹  Mustafa Cikirikcioglu¹  Patrick O Myers¹ 

[1] Cardiovascular Surgery, Geneva University Hospitals & Faculty of Medicine, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva, Switzerland

关键词: Biodegradable materials;    Valve repair;    Endocarditis;   

Others  :  1123278
DOI  :  10.1186/1471-2482-14-48

 received in 2014-02-25, accepted in 2014-07-24,  发布年份 2014

【 摘 要 】

Background

One third of patients with infective endocarditis will require operative intervention. Given the superiority of valve repair over valve replacement in many indications other than endocarditis, there has been increasing interest and an increasing number of reports of excellent results of valve repair in acute infective endocarditis. The theoretically ideal material for valve repair in this setting is non-permanent, “vanishing” material, not at risk of seeding or colonization. The goal of this contribution is to review currently available data on biodegradable materials for valve repair in infective endocarditis.

Discussion

Rigorous electronic and manual literature searches were conducted to identify reports of biodegradable materials for valve repair in infective endocarditis. Articles were identified in electronic database searches of Medline, Embase and the Cochrane Library, using a predetermined search strategy. 49 manuscripts were included in the review. Prosthetic materials needed for valve repair can be summarized into annuloplasty rings to remodel the mitral or tricuspid annulus, and patch materials to replace resected valvar tissue. The commercially available biodegradable annuloplasty ring has shown interesting clinical results in a single-center experience; however further data is required for validation and longer follow-up. Unmodified extra-cellular matrix patches, such as small intestinal submucosa, have had promising initial experimental and clinical results in non-infected valve repair, although in valve repair for endocarditis has been reported in only one patient, and concerns have been raised regarding their mechanical stability in an infected field.

Summary

These evolving biodegradable devices offer the potential for valve repair with degradable materials replaced with autologous tissue, which could further improve the results of valve repair for infective endocarditis. This is an evolving field with promising experimental or initial clinical results, however long-term outcomes are lacking and further data is necessary to validate this theoretically interesting approach to infective endocarditis.

【 授权许可】

   
2014 Myers et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Hoen B, Chirouze C, Cabell CH, Selton-Suty C, Duchene F, Olaison L, Miro JM, Habib G, Abrutyn E, Eykyn S, Bernard Y, Marco F, Corey GR: Emergence of endocarditis due to group D streptococci: findings derived from the merged database of the International Collaboration on Endocarditis. Eur J Clin Microbiol Infect Dis 2005, 24(1):12-16.
• [2]Hogevik H, Olaison L, Andersson R, Lindberg J, Alestig K: Epidemiologic aspects of infective endocarditis in an urban population. A 5-year prospective study. Medicine (Baltimore) 1995, 74(6):324-339.
• [3]van der Meer JT, Thompson J, Valkenburg HA, Michel MF: Epidemiology of bacterial endocarditis in The Netherlands. I. Patient characteristics. Arc Internal Med 1992, 152(9):1863-1868.
• [4]Thuny F, Di Salvo G, Belliard O, Avierinos JF, Pergola V, Rosenberg V, Casalta JP, Gouvernet J, Derumeaux G, Iarussi D, Ambrosi P, Calabro R, Riberi A, Collart F, Metras D, Lepidi H, Raoult D, Harle JR, Weiller PJ, Cohen A, Habib G: Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study. Circulation 2005, 112(1):69-75.
• [5]Thuny F, Grisoli D, Collart F, Habib G, Raoult D: Management of infective endocarditis: challenges and perspectives. Lancet 2012, 379(9819):965-975.
• [6]Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, Ferrieri P, Gerber MA, Tani LY, Gewitz MH, Tong DC, Steckelberg JM, Baltimore RS, Shulman ST, Burns JC, Falace DA, Newburger JW, Pallasch TJ, Takahashi M, Taubert KA: Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation 2005, 111(23):e394-e434.
• [7]Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, Moreillon P, de Jesus AM, Thilen U, Lekakis J, Lengyel M, Muller L, Naber CK, Nihoyannopoulos P, Moritz A, Zamorano JL: Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 2009, 30(19):2369-2413.
• [8]Hill EE, Herijgers P, Herregods MC, Peetermans WE: Evolving trends in infective endocarditis. Clin Microbiol Infect 2006, 12(1):5-12.
• [9]Fedoruk LM, Jamieson WR, Ling H, Macnab JS, Germann E, Karim SS, Lichtenstein SV: Predictors of recurrence and reoperation for prosthetic valve endocarditis after valve replacement surgery for native valve endocarditis. J Thorac Cardiovasc Surg 2009, 137(2):326-333.
• [10]Musci M, Hubler M, Pasic M, Amiri A, Stein J, Siniawski H, Weng Y, Hetzer R: Surgery for active infective mitral valve endocarditis: a 20-year, single-center experience. J Heart Valve Dis 2010, 19(2):206-214. discussion 215
• [11]Schaff HV, Carrel TP, Jamieson WR, Jones KW, Rufilanchas JJ, Cooley DA, Hetzer R, Stumpe F, Duveau D, Moseley P, van Boven WJ, Grunkemeier GL, Kennard ED, Holubkov R: Paravalvular leak and other events in silzone-coated mechanical heart valves: a report from AVERT. Ann Thorac Surg 2002, 73(3):785-792.
• [12]Kuijpers AJ, Engbers GH, van Wachem PB, Krijgsveld J, Zaat SA, Dankert J, Feijen J: Controlled delivery of antibacterial proteins from biodegradable matrices. J Control Release 1998, 53(1–3):235-247.
• [13]Jassar AS, Bavaria JE, Szeto WY, Moeller PJ, Maniaci J, Milewski RK, Gorman JH 3rd, Desai ND, Gorman RC, Pochettino A: Graft selection for aortic root replacement in complex active endocarditis: does it matter? Ann Thorac Surg 2012, 93(2):480-487.
• [14]Baird CW, Myers PO, Marx G, Del Nido PJ: Mitral valve operations at a high-volume pediatric heart center: Evolving techniques and improved survival with mitral valve repair versus replacement. Ann Pediatr Cardiol 2012, 5(1):13-20.
• [15]DiBardino DJ, ElBardissi AW, McClure RS, Razo-Vasquez OA, Kelly NE, Cohn LH: Four decades of experience with mitral valve repair: analysis of differential indications, technical evolution, and long-term outcome. J Thorac Cardiovasc Surg 2010, 139(1):76-83. discussion 83–74
• [16]de Kerchove L, Vanoverschelde JL, Poncelet A, Glineur D, Rubay J, Zech F, Noirhomme P, El Khoury G: Reconstructive surgery in active mitral valve endocarditis: feasibility, safety and durability. Eur J Cardiothorac Surg 2007, 31(4):592-599.
• [17]Scher KS, Bernstein JM, Jones CW: Infectivity of vascular sutures. Am Surg 1985, 51(10):577-579.
• [18]Katz S, Izhar M, Mirelman D: Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg 1981, 194(1):35-41.
• [19]Merritt K, Hitchins VM, Neale AR: Tissue colonization from implantable biomaterials with low numbers of bacteria. J Biomed Mater Res 1999, 44(3):261-265.
• [20]Sharp WV, Belden TA, King PH, Teague PC: Suture resistance to infection. Surgery 1982, 91(1):61-63.
• [21]Carpentier A: Cardiac valve surgery–the “French correction”. J Thorac Cardiovasc Surg 1983, 86(3):323-337.
• [22]Hetzer R, Delmo Walter EM: No ring at all in mitral valve repair: indications, techniques and long-term outcome. Eur J Cardiothorac Surg 2014, 45(2):341-351.
• [23]Monahan TS, Phaneuf MD, Contreras MA, Andersen ND, Popescu-Vladimir A, Bide MJ, Dempsey DJ, Mitchell RN, Hamdan AD, LoGerfo FW: In vivo testing of an infection-resistant annuloplasty ring. J Surg Res 2006, 130(1):140-145.
• [24]Duran CM, Balasundaram SG, Bianchi S, Herdson P: The vanishing tricuspid annuloplasty. A new concept. J Thorac Cardiovasc Surg 1992, 104(3):796-801.
• [25]Duran CM, Kumar N, Prabhakar G, Ge Z, Bianchi S, Gometza B: Vanishing De Vega annuloplasty for functional tricuspid regurgitation. J Thorac Cardiovasc Surg 1993, 106(4):609-613.
• [26]Kalangos A, Sierra J, Vala D, Cikirikcioglu M, Walpoth B, Orrit X, Pomar J, Mestres C, Albanese S, Jhurry D: Annuloplasty for valve repair with a new biodegradable ring: an experimental study. J Heart Valve Dis 2006, 15(6):783-790.
• [27]Cikirikcioglu M, Cherian S, Stimec B, Theologou T, Myers PO, Fasel J, Kalangos A: Morphologic and angiographic analysis to assess the safety of a biodegradable mitral annuloplasty ring. J Heart Valve Dis 2011, 20(2):199-204.
• [28]Kalangos A, Christenson JT, Beghetti M, Cikirikcioglu M, Kamentsidis D, Aggoun Y: Mitral valve repair for rheumatic valve disease in children: midterm results and impact of the use of a biodegradable mitral ring. Ann Thorac Surg 2008, 86(1):161-168. discussion 168–169
• [29]Bautista-Hernandez V, Myers PO, Loyola H, Marx GR, Bacha EA, Baird CW, del Nido PJ: Atrioventricular Valve Annular Remodeling With a Bioabsorbable Ring in Young Children. J Am Coll Cardiol 2012, 60(21):2256-2258.
• [30]Myers PO, Beghetti M, Kalangos A: Biodegradable mitral annuloplasty for congenital ischemic mitral regurgitation. Thorac Cardiovasc Surg 2009, 57(6):363-364.
• [31]Mrowczynski W, Mrozinski B, Kalangos A, Walpoth BH, Pawelec-Wojtalik M, Wojtalik M: A biodegradable ring enables growth of the native tricuspid annulus. J Heart Valve Dis 2011, 20(2):205-215.
• [32]Panos A, Myers PO, Kalangos A: Thoracoscopic and robotic tricuspid valve annuloplasty with a biodegradable ring: an initial experience. J Heart Valve Dis 2010, 19(2):201-205.
• [33]Pektok E, Ekici AID, Kucukaksu S: Biodegradable Annuloplasty Ring Two Years after Implantation: First Histological Demonstration in Human Mitral Annulus. J Heart Valve Dis 2013, 22(3):445-447.
• [34]Kazaz H, Celkan MA, Ustunsoy H, Baspinar O: Mitral annuloplasty with biodegradable ring for infective endocarditis: a new tool for the surgeon for valve repair in childhood. Interact Cardiovasc Thorac Surg 2005, 4(4):378-380.
• [35]Pektok E, Sierra J, Cikirikcioglu M, Muller H, Myers PO, Kalangos A: Midterm results of valve repair with a biodegradable annuloplasty ring for acute endocarditis. Ann Thorac Surg 2010, 89(4):1180-1185.
• [36]Myers PO, Kalangos A, Pektok E, Cikirikcioglu M: Biodegradable ring annuloplasty for valve repair in children with endocarditis. J Card Surg 2012, 27(3):393. author reply 394
• [37]Myers PO, Tissot C, Christenson JT, Cikirikcioglu M, Aggoun Y, Kalangos A: Aortic valve repair by cusp extension for rheumatic aortic insufficiency in children: Long-term results and impact of extension material. J Thorac Cardiovasc Surg 2010, 140(4):836-844.
• [38]Nosal M, Poruban R, Valentik P, Sagat M, Nagi AS, Kantorova A: Initial experience with polytetrafluoroethylene leaflet extensions for aortic valve repair. Eur J Cardiothorac Surg 2012, 41(6):1255-1257. discussion 1258
• [39]El Khoury G, Vohra HA: Polytetrafluoroethylene leaflet extensions for aortic valve repair. Eur J Cardiothorac Surg 2012, 41(6):1258-1259.
• [40]Farivar RS, Shernan SK, Cohn LH: Late rupture of polytetrafluoroethylene neochordae after mitral valve repair. J Thorac Cardiovasc Surg 2009, 137(2):504-506.
• [41]Kalfa D, Bel A, Chen-Tournoux A, Della Martina A, Rochereau P, Coz C, Bellamy V, Bensalah M, Vanneaux V, Lecourt S, Mousseaux E, Bruneval P, Larghero J, Menasche P: A polydioxanone electrospun valved patch to replace the right ventricular outflow tract in a growing lamb model. Biomaterials 2010, 31(14):4056-4063.
• [42]Sutherland FW, Perry TE, Yu Y, Sherwood MC, Rabkin E, Masuda Y, Garcia GA, McLellan DL, Engelmayr GC Jr, Sacks MS, Schoen FJ, Mayer JE Jr: From stem cells to viable autologous semilunar heart valve. Circulation 2005, 111(21):2783-2791.
• [43]Badylak SF: The extracellular matrix as a scaffold for tissue reconstruction. Semin Cell Dev Biol 2002, 13(5):377-383.
• [44]Quarti A, Nardone S, Colaneri M, Santoro G, Pozzi M: Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases. Interact Cardiovasc Thorac Surg 2011, 13(6):569-572.
• [45]Padalino MA, Castellani C, Dedja A, Fedrigo M, Vida VL, Thiene G, Stellin G, Angelini A: Extracellular matrix graft for vascular reconstructive surgery: evidence of autologous regeneration of the neoaorta in a murine model. Eur J Cardiothorac Surg 2012, 42(5):e128-135.
• [46]Myers PO, Khalpey Z, Baird CW, Nathan M, Del Nido PJ: In vivo Valvulogenesis: Initial Experience with Atrioventricular Valve Leaflet Augmentation with CorMatrix® Extracellular Matrix Scaffolds. Circulation 2012, 126:A16130.
• [47]Sundermann SH, Rodriguez Cetina Biefer H, Emmert MY, Falk V: Use of extracellular matrix materials in patients with endocarditis. Thor Cardiovasc Surg 2014, 62(1):76-79.
• [48]Cevasco M, Itani KM: Ventral hernia repair with synthetic, composite, and biologic mesh: characteristics, indications, and infection profile. Surg Infect 2012, 13(4):209-215.
• [49]Bellows CF, Wheatley BM, Moroz K, Rosales SC, Morici LA: The effect of bacterial infection on the biomechanical properties of biological mesh in a rat model. PLoS One 2011, 6(6):e21228.