Early Degeneration of Extracellular Matrix Used for Aortic Reconstruction During the Norwood Operation

Erek, Ersin; Aydın, Selim; Suzan, Dilek; Yıldız, Okan; Demir, İbrahim; Ödemiş, Ender

doi:10.1016/j.athoracsur.2015.04.051

Cited by 16 publications

(15 citation statements)

References 5 publications

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“…In addition to cases of carotid 3,4 and femoral endarterectomy, failures have been reported in multiple other applications. [5][6][7] Studies evaluating patch tensile strength at various temporal stages after implantation suggest that failure results from an early decline in patch integrity. Such findings are consistent with the time frame during which complications have been observed.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

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Early complications of biologic extracellular matrix patch after use for femoral artery repair

Dobrilovic

Soukas

Sadiq

et al. 2017

Journal of Vascular Surgery

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Section: Journal Of Vascular Surgerymentioning

confidence: 99%

“…3 Other reports document deficiencies in healing, resulting in significant complications. [3][4][5][6][7] The initial impetus for this report was to examine the feasibility of implanting a CorMatrix patch as part of a femoral endarterectomy procedure. Outcomes are reported with an emphasis on complications.…”

mentioning

confidence: 99%

Early complications of biologic extracellular matrix patch after use for femoral artery repair

Dobrilovic

Soukas

Sadiq

et al. 2017

Journal of Vascular Surgery

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“…Furthermore, it has been proven that the remaining and unremoved allogeneic or xenogeneic cellular debris may adversely affect the promotion of the regenerative processes of biological scaffolds in vivo upon transplantation . Therefore, the use of tissue engineering techniques, including the procedures for tissue and organ decellularization, can be an element critical for clinical success . The remarkable research already undertaken leaves fertile ground for an immense still field of further research.…”

Section: Introductionmentioning

confidence: 99%

“…48,49 Therefore, the use of tissue engineering techniques, including the procedures for tissue and organ decellularization, can be an element critical for clinical success. [49][50][51][52][53] The remarkable research already undertaken leaves fertile ground for an immense still field of further research.…”

Section: Introductionmentioning

confidence: 99%

A review of decellurization methods caused by an urgent need for quality control of cell‐free extracellular matrix' scaffolds and their role in regenerative medicine

et al. 2017

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The natural extracellular matrix (ECM),thanks to its specific properties (e.g., collagenous lattice, a reservoir of growth factors, ECM-cell anchoring areas, an optimal pH and CO ),ensures an optimal microenvironment for homeostatic and regenerative cell development. In the context of regenerative medicine, ECM is a lair for residual and infiltrative cells. The aim of the clinical usage of cell-free ECM scaffolds is the enhancement of tissue regeneration with possible minimization of an adverse host reaction on allogeneic or xenogeneic biomaterial. Thus, the objective of decellularization is to obtain acellular grafts characterized by optimal biological properties, such as a lack of remaining cellular elements (e.g., cell membrane phospholipids and proteins, nucleic acids, mitochondria), lack of immunogenicity, lack of calcification promotion and lack of cytotoxicity (e.g., in unrinsed detergents). Furthermore, cell-free ECM scaffolds should present the optimal mechanical and structural properties that may ensure the biocompatibility of the graft. The maintenance of the ultrastructure composition of the ECM is one of the most important goals of decellularization. All physical, chemical, and biological methods proposed (used separately or in combination to extract cells from tissues/organs) are not 100% effective in cell removal and always cause a disruption of the ECM texture, as well as a probable loss of important structure components. Although cell-free ECM scaffolds are generally classified as medical devices, there are no widely accepted or legally defined criteria for quality control/evaluation methods of obtained matrices. Such criteria must be provided. Some of them have been proposed in this manuscript. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 909-923, 2018.

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“…Thirteen of them underwent bidirectional Glenn operation in Group N. Three of them had additional aortic patch replacement due to aneurysmal degeneration of CorMatrix (small intestinal submucosa extracellular matrix; CorMatrix Cardiovascular Inc., GA, USA) patch (Figure 3). [12] One patient had additional tricuspid valve annuloplasty. Fourteen of the patients (21.5%) in Group H had comprehensive Stage II (Norwood+Glenn) operation and five of the patients (7.6%) with the diagnosis of HLHC in Group H underwent biventricular repair.…”

Section: Second Stagementioning

confidence: 99%

Outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants

Erek

Aydın

Temur

et al. 2020

Turk Gogus Kalp Dama

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Bu çalışmada, hipoplastik sol kalp sendromu ve varyantlarının tedavisinde hibrit ve Norwood Aşama I işlemlerinin sonuçları sunuldu. Ça lış ma pla nı: Bu çalışmada Mart 2011-Ekim 2018 tarihleri arasında hipoplastik sol kalp sendromu veya varyantları nedeniyle ameliyat edilen toplam 97 pediatrik hasta retrospektif olarak değerlendirildi. Hastaların 32'sine (28 erkek, 4 kız; medyan yaş 5 gün; dağılım 1-25 gün) Norwood Aşama I ameliyatı (Grup N) yapılırken, geriye kalan 65 hastaya (44 erkek, 21 kız; medyan yaş 6 gün; dağılım 1-55 gün) hibrit Aşama I ameliyatı (Grup H) uygulandı. Her iki tedavi stratejisi karşılaştırıldı. Bul gu lar: Grup N'ye kıyasla Grup H'nin medyan kilosu anlamlı düzeyde daha düşük olup, düşük doğum ağırlığı (<2500 g) olan hasta sayısı anlamlı düzeyde daha yüksek idi. Ameliyat sonrası erken mortalite gruplar arasında benzerdi. Tek değişkenli ve çok değişkenli analizler, ameliyat öncesi mekanik ventilasyon ihtiyacının mortalite açısından anlamlı bir faktör olduğunu gösterdi (sırasıyla, p= 0.004 ve 0.003). Sendromik görünüm de, çok değişkenli analizde anlamlı bir faktör idi (p= 0.03). Aşamalar arasında mortalite oranları açısından gruplar arasında istatistiksel olarak anlamlı bir fark vardı. Toplam 32 hastaya ikinci aşama işlem uygulandı. Glenn ameliyatı sonrasında erken mortalite oranı %7.6 idi. Kapsamlı Aşama II operasyonu sonrasında altı hasta kaybedildi. Beş hastaya biventriküler tamir ve 8 hastaya üçüncü aşama fenestre ekstrakardiyak Fontan ameliyatı yapıldı (Grup N, n=7 ve Grup H, n=1). Kaplan-Meier sağkalım eğrisi, sağkalım oranının hem bir hem de beşinci yıllarda Grup H'ye kıyasla Grup N'de daha yüksek olduğunu göstermekle birlikte, fark istatistiksel olarak anlamlı değildi (p= 0.15). Alt grup analizi, Sano modifikasyonu ile birlikte Norwood işleminin beşinci yılda %40 ile en yüksek sağkalım oranına sahip olduğunu gösterdi. So nuç: Çalışma sonuçlarımız, Aşama I işlemi sonrasında erken dönemde görülen zorluklara rağmen, Norwood işlemi yapılan hastaların aşamalar arası dönemde ve Aşama II ve III'te daha sorunsuz bir seyir izlediğini göstermektedir. Deneyimlerimize dayanarak, klinik durumu kötü olan ve kilosu <2500 g olan hastalarda hibrit girişim yapılmasını önermekteyiz. Anah tarsöz cük ler: Konjenital kalp anomalileri, hipoplastik sol kalp sendromu, yenidoğan, Norwood operasyonu, palyatif cerrahi.

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Early Degeneration of Extracellular Matrix Used for Aortic Reconstruction During the Norwood Operation

Cited by 16 publications

References 5 publications

Early complications of biologic extracellular matrix patch after use for femoral artery repair

Early complications of biologic extracellular matrix patch after use for femoral artery repair

A review of decellurization methods caused by an urgent need for quality control of cell‐free extracellular matrix' scaffolds and their role in regenerative medicine

Outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants

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