Effectiveness of a novel, completely biomaterial valved pulmonary arterial conduit: An in�vivo study

Abstract

As a pre-clinical assessment, the present study aimed to investigate the safety and effectiveness of a novel valved pulmonary arterial conduit constructed entirely from biomaterials by transplanting it in the outflow tract of the right ventricle in sheep. Under extracorporeal circulation, the valved pulmonary arterial conduit was used to replace the pulmonary artery of sheep with a beating heart. The performance was assessed at 30, 90 and 180 days post-surgery. Hemodynamic and structural changes were evaluated, and safety was assessed after 180 postoperative days. The hemodynamic effect and biosafety of the implant were further evaluated by observing the changes in various pressure indicators of the heart, echocardiographic results, anatomical and pathological examination results, liver and kidney functions, routine blood tests, a blood coagulation test, and other test results following implantation of the purely biotic valved conduit. The conduit was successfully implanted in 12 sheep and no mortality occurred postoperatively. During the 180-day follow-up, there was no obvious stenosis or regurgitation of the right ventricular outflow tract and pulmonary valve after valved conduit implantation. The findings of autopsy, pathology and laboratory examinations were unremarkable. The implantation of this biosynthetic vascular graft into animals meets the safety and effectiveness requirements for clinical application. This pulmonary arterial conduit has potential clinical application for children with complex congenital heart disease who require pulmonary artery reconstruction to achieve a radical cure.

A decellularized porcine pulmonary valved conduit embedded with gelatin

“…Because of its mild temperament, convenient feeding and examination, and its similar hemodynamics, hemorheology, and immunology to those of humans, sheep are the most commonly used animal for in vivo experiments with PVCs 13,36 and tissue-engineered valves. 37 The tissue-engineered PVCs implanted in sheep initiate a self-repair process.…”

“…Compared with other studies, the calcium content in the Crs-P2 group was lower than that of the decellularized bovine pericardium valved conduit in the half-year sheep model. 36 This anticalcification effect may be related to the weakening of chronic rejection, reducing inflammation and promoting self-repair after EDC crosslinking.…”