Assessment of degradability and endothelialization of modified poly L-lactic acid (PLLA) atrial septal defect (ASD) occluders over time in vivo

Journal of Cardiothoracic Surgery

Research

Yifan Li¹  Yumei Xie¹  Xianmiao Chen²  Yanfen Liu²  Mingjuan Fu²  Zhiwei Zhang³  Jun Chen⁴ 

[1] Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, No. 106 Zhongshan Second Road, Yuexiu District, 510100, Guangzhou, Guangdong, China;Lifetech Scientific (Shenzhen) Co., Ltd., 518057, Shenzhen, Guangdong, China;The Second School of Clinical Medicine, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, No. 106 Zhongshan Second Road, Yuexiu District, 510100, Guangzhou, Guangdong, China;The Second School of Clinical Medicine, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, No. 106 Zhongshan Second Road, Yuexiu District, 510100, Guangzhou, Guangdong, China;Danzhou People’s Hospital, 571700, Danzhou, Hainan, China;

关键词: Atrial septal defect;    Poly L-lactic acid;    Occluder;    Degradability;    Endothelialization;    Congenital heart disease;   

DOI  :  10.1186/s13019-023-02401-3

 received in 2023-03-27, accepted in 2023-09-30,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveTo evaluate the fiber-degradation and endothelialization of a modified poly L-lactic acid (PLLA) atrial septal defect (ASD) occluder for a long time in vivo.MethodsA total of 57 New Zealand rabbits were selected to establish the vasculature implantation model, which would be used to characterize the mechanical properties and pathological reaction of PLLA filaments (a raw polymer of ASD occluder). In total, 27 Experimental piglets were used to create the ASD model for the catheter implantation of PLLA ASD occluders. Then, X-ray imaging, transthoracic echocardiography, histopathology, and scanning electron microscope (SEM) were performed in the experimental animals at 3, 6, 12, and 24 months after implantation.ResultsIn the rabbit models, the fibrocystic grade was 0 and the inflammatory response was grade 2 at 6 months after vasculature implantation of the PLLA filaments. The mass loss of PLLA filaments increased appreciably with the increasing duration of implantation, but their mechanical strength was decreased without broken. In the porcine models, the cardiac gross anatomy showed that all PLLA ASD occluders were stable in the interatrial septum without any vegetation or thrombus formation. At 24 months, the occluders had been embedded into endogenous host tissue nearly. Pathological observations suggested that the occluders degraded gradually without complications at different periods. SEM showed that the occluders were endothelialized completely and essentially became an integral part of the body over time.ConclusionIn the animal model, the modified PLLA ASD occluders exhibited good degradability and endothelialization in this long-term follow-up study.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3

Fig. 14

Fig. 9

Fig. 4

12936_2015_836_Article_IEq13.gif

Fig. 4

Fig. 2

Fig. 1

12951_2017_292_Article_IEq1.gif