Outcomes of Repair of Congenital Aortic Valve Lesions Using Autologous Pericardium vs Porcine Intestinal Submucosa

Sengupta, Aditya; Beroukhim, Rebecca S.; Baird, Christopher W.; Nido, Pedro J. del; Geva, Tal; Marcus, Edward; Sanders, Stephen P.; Nathan, Meena

doi:10.1016/j.jacc.2022.06.029

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…Ever since 1998, when SIS was cleared by the FDA for its first clinical applications in wound repair [ 6 ], ECM-based porcine SIS has exhibited good biocompatibility and low immunogenicity when reconstructing various types of tissues, including those involving urological diseases such as hypospadias [ 2 ] and urinary bladder reconstruction after cystectomy [ 7 ]; gynecological illnesses such as cervicovaginal reconstruction [ 4 ] and pelvic organ prolapse [ 8 ]; and chronic poor healing wounds such as diabetic foot ulcers [ 9 ] and stage III or IV pressure ulcers [ 10 ]. Moreover, SIS has been used for focal tissue repair in the eardrum [ 1 ] and heart valves [ 11 ] and for bone augmentation in animal studies [ 12 ]. However, the outcomes remain uncertain in several fields in which SIS is used [ 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, SIS has been used for focal tissue repair in the eardrum [ 1 ] and heart valves [ 11 ] and for bone augmentation in animal studies [ 12 ]. However, the outcomes remain uncertain in several fields in which SIS is used [ 8 , 11 ]. For instance, one retrospective study using SIS in the repair of pelvic organ prolapse revealed the relatively high complication rates (56%) after the operations, leading to the suggestion of little benefit of SIS graft in prolapse surgery [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, one retrospective study using SIS in the repair of pelvic organ prolapse revealed the relatively high complication rates (56%) after the operations, leading to the suggestion of little benefit of SIS graft in prolapse surgery [ 8 ]. Another study in the pediatric congenital aortic valve repair found a shorter time interval to reintervention and significantly higher odds ratio of the occurrence of moderate aortic regurgitation or stenosis when using SIS compared to the use of autologous pericardium [ 11 ]. While SIS holds the potential to promote constructive remodeling at site-appropriate functional tissue [ 13 ], whether this material needs to be pretreated or surface-modified before site-specific implantation to increase clinical efficacy warrants more investigation.…”

Section: Introductionmentioning

confidence: 99%

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Degassing a Decellularized Scaffold Enhances Wound Healing and Reduces Fibrosis during Tracheal Defect Reconstruction: A Preliminary Animal Study

Viet-Nhi

Chen

Dang

et al. 2023

JFB

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Few efforts have been made regarding the optimization of porcine small intestinal submucosa (SIS) to improve its biocompatibility. This study aims to evaluate the effect of SIS degassing on the promotion of cell attachment and wound healing. The degassed SIS was evaluated in vitro and in vivo, compared with the nondegassed SIS control. In the cell sheet reattachment model, the reattached cell sheet coverage was significantly higher in the degassed SIS group than in the nondegassed group. Cell sheet viability was also significantly higher in the SIS group than in the control group. In vivo studies showed that the tracheal defect repaired by the degassed SIS patch showed enhanced healing and reductions in fibrosis and luminal stenosis compared to the nondegassed SIS control group, with the thickness of the transplanted grafts in the degassed SIS group significantly lower than those in the control group (346.82 ± 28.02 µm vs. 771.29 ± 20.41 µm, p < 0.05). Degassing the SIS mesh significantly promoted cell sheet attachment and wound healing by reducing luminal fibrosis and stenosis compared to the nondegassed control SIS. The results suggest that the degassing processing might be a simple and effective way to improve the biocompatibility of SIS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Degassing a Decellularized Scaffold Enhances Wound Healing and Reduces Fibrosis during Tracheal Defect Reconstruction: A Preliminary Animal Study

Viet-Nhi

Chen

Dang

et al. 2023

JFB

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“…Although several studies have reported encouraging results ( Badylak et al, 1989 ; Lantz et al, 1992 ; Fallon et al, 2012 ; Padalino et al, 2012 ; Baker et al, 2019 ), incomplete cellularity of the final product has been observed, which is responsible for immune rejection, calcification, and fibrosis ( Woo et al, 2016 ; Nelson et al, 2016 ; Sood et al, 2021 ). Therefore, the clinical results obtained with the use of CorMatrix are controversial ( Quarti et al, 2011 ; Rosario-Quinones et al, 2015 ; Nezhad et al, 2017 ; Sengupta et al, 2022 ; Ma, 2022 ). A more sophisticated and specific type of decellularization process, associated with a dedicated sterilization protocol, will contribute to optimizing SIS performance.…”

Section: Introductionmentioning

confidence: 99%

Small intestinal submucosa-derived extracellular matrix as a heterotopic scaffold for cardiovascular applications

Palmosi

Tolomeo

Cirillo

et al. 2022

Front. Bioeng. Biotechnol.

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Structural cardiac lesions are often surgically repaired using prosthetic patches, which can be biological or synthetic. In the current clinical scenario, biological patches derived from the decellularization of a xenogeneic scaffold are gaining more interest as they maintain the natural architecture of the extracellular matrix (ECM) after the removal of the native cells and remnants. Once implanted in the host, these patches can induce tissue regeneration and repair, encouraging angiogenesis, migration, proliferation, and host cell differentiation. Lastly, decellularized xenogeneic patches undergo cell repopulation, thus reducing host immuno-mediated response against the graft and preventing device failure. Porcine small intestinal submucosa (pSIS) showed such properties in alternative clinical scenarios. Specifically, the US FDA approved its use in humans for urogenital procedures such as hernia repair, cystoplasties, ureteral reconstructions, stress incontinence, Peyronie’s disease, penile chordee, and even urethral reconstruction for hypospadias and strictures. In addition, it has also been successfully used for skeletal muscle tissue reconstruction in young patients. However, for cardiovascular applications, the results are controversial. In this study, we aimed to validate our decellularization protocol for SIS, which is based on the use of Tergitol 15 S 9, by comparing it to our previous and efficient method (Triton X 100), which is not more available in the market. For both treatments, we evaluated the preservation of the ECM ultrastructure, biomechanical features, biocompatibility, and final bioinductive capabilities. The overall analysis shows that the SIS tissue is macroscopically distinguishable into two regions, one smooth and one wrinkle, equivalent to the ultrastructure and biochemical and proteomic profile. Furthermore, Tergitol 15 S 9 treatment does not modify tissue biomechanics, resulting in comparable to the native one and confirming the superior preservation of the collagen fibers. In summary, the present study showed that the SIS decellularized with Tergitol 15 S 9 guarantees higher performances, compared to the Triton X 100 method, in all the explored fields and for both SIS regions: smooth and wrinkle.

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State of the Art Review: Aortic Valve Repair in Infants and Children

Chiu,

Higgins,

Baird

2024

The Annals of Thoracic Surgery

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Outcomes of Repair of Congenital Aortic Valve Lesions Using Autologous Pericardium vs Porcine Intestinal Submucosa

Cited by 7 publications

References 26 publications

Degassing a Decellularized Scaffold Enhances Wound Healing and Reduces Fibrosis during Tracheal Defect Reconstruction: A Preliminary Animal Study

Degassing a Decellularized Scaffold Enhances Wound Healing and Reduces Fibrosis during Tracheal Defect Reconstruction: A Preliminary Animal Study

Small intestinal submucosa-derived extracellular matrix as a heterotopic scaffold for cardiovascular applications

State of the Art Review: Aortic Valve Repair in Infants and Children

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