Pericardial tissue for cardiovascular application: an in-vitro evaluation of established and advanced production processes

Grefen, Linda; König, Fabian; Grab, Maximilian; Hagl, Christian; Thierfelder, Nikolaus

doi:10.1007/s10856-018-6186-6

Cited by 12 publications

(9 citation statements)

References 46 publications

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“…From a mechanical point of view, the implication of such an elongation might be related to an increase in tensile strength observed in the GA-treated autologous pericardium with respect to native aortic valve leaflets [18]. Both the histological and SEM analysis also revealed that the mesothelial side of the GA-treated pericardium displayed denudation across the surface, which may be due to tissue processing, as described by others for bovine pericardium [19].…”

Section: Discussionmentioning

confidence: 59%

“…Then, the number of cells was compared to that of HUVEC adhering on the BP control membranes after 4 days of culture, as performed by others on bovine pericardium substrates [30,31]. Endothelial cells have been chosen because, among the different cell populations, they better mimic a physiological environment in cardiovascular applications [19]. In particular, endothelial cells play a regulatory role to the cardiac valve function, by sensing and integrating biological and mechanical signals from the blood, and by transmitting them to the underlying tissue [24].…”

Section: Discussionmentioning

confidence: 99%

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Biological Characterization of Human Autologous Pericardium Treated with the Ozaki Procedure for Aortic Valve Reconstruction

Gardin

Morciano

Ferroni

et al. 2021

JCM

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Background: The Ozaki procedure is an innovative surgical technique aiming at reconstructing aortic valves with human autologous pericardium. Even if this procedure is widely used, a comprehensive biological characterization of the glutaraldehyde (GA)-fixed pericardial tissue is still missing. Methods: Morphological analysis was performed to assess the general organization of pericardium subjected to the Ozaki procedure (post-Ozaki) in comparison to native tissue (pre-Ozaki). The effect of GA treatment on cell viability and nuclear morphology was then investigated in whole biopsies and a cytotoxicity assay was executed to assess the biocompatibility of pericardium. Finally, human umbilical vein endothelial cells were seeded on post-Ozaki samples to evaluate the influence of GA in modulating the endothelialization ability in vitro and the production of pro-inflammatory mediators. Results: The Ozaki procedure alters the arrangement of collagen and elastic fibers in the extracellular matrix and results in a significant reduction in cell viability compared to native tissue. GA treatment, however, is not cytotoxic to murine fibroblasts as compared to a commercially available bovine pericardium membrane. In addition, in in vitro experiments of endothelial cell adhesion, no difference in the inflammatory mediators with respect to the commercial patch was found. Conclusions: The Ozaki procedure, despite alteration of ECM organization and cell devitalization, allows for the establishment of a noncytotoxic environment in which endothelial cell repopulation occurs.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Biological Characterization of Human Autologous Pericardium Treated with the Ozaki Procedure for Aortic Valve Reconstruction

Gardin

Morciano

Ferroni

et al. 2021

JCM

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“…There is a large amount of research performed to find the ideal biomaterial for cardiovascular repair, corrective and reconstructive surgery. 1,4,5,78 Most of the studies on new materials, such as extracellular matrix patches, decellularized tissues (►Table 2), and different fixation treatments, are mainly conducted in vitro to evaluate their structural and biomechanical properties. 78,79 Some of these new materials have been already used clinically but the results are limited and, in some cases, unexpectedly unfavorable so further research has been recommended.…”

Section: Discussionmentioning

confidence: 99%

Use of Pericardium for Cardiac Reconstruction Procedures in Acquired Heart Diseases—A Comprehensive Review

Martino¹,

Milano

Bortolotti³

2019

Thorac Cardiovasc Surg

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Background Reconstruction of cardiac structures has been the goal of many surgeons even before the advent of open-heart procedures with cardiopulmonary bypass. Unsatisfactory results with synthetic materials has switched the attention to biological tissues, among which pericardium, either autologous or of animal origin, has been widely used as patch material. Methods We have reviewed the literature to assess the effective role of pericardial tissue in the correction of various acquired cardiac lesions. Particularly, special attention was given not only to established techniques but also to detect any peculiar and unusual application of pericardium. Results Autologous pericardium is frequently used as patch material particularly when limited valvular lesions must be corrected, while xenograft pericardium appears particularly useful in patients with endocarditis and extensive destruction of the intracardiac structures by infection and abscesses. Pericardium is an extremely versatile material owing to its pliability and strength; however, it tends to calcify in the long term when in contact with blood, although stability of the repair is maintained in most cases. Conclusions Pericardium plays an important role in various cardiac and aortic pathologies. Tissues resistant to fibrosis and calcification to be used as patch material are the ideal solution for more successful cardiac reconstruction procedures and will hopefully be provided by the ongoing research.

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“…In general, the histoarchitecture of the tissue appeared well preserved and in agreement with the literature data and with the results we obtained using porcine pericardia. 10,28,31,41,42 For a more detailed investigation of collagen fiber structure and alignment, as it was shown for SULEEI-treated porcine pericardium, scanning electron microscopy will be used in ongoing studies. 31,48,49 The preservation of SULEEI-treated bovine tissue morphology led to the assumption that the biodegradability and biomechanical behavior of the SULEEI-treated bovine pericardium would be equivalent to that of the clinically available patch material.…”

Section: Histomorphology and Decellularizationmentioning

confidence: 99%

“…10,[23][24][25] The resulting tissue has properties that are reflected by biomechanical behavior usually measured by uniaxial tensile testing, with the end points of ultimate tensile strength, Young's modulus (elasticity), and strain at rupture. [26][27][28][29] Investigations on the mechanical features of glutaraldehyde-treated bovine pericardium revealed that the material has an acceptable stability. 26 This is also concluded from the durability of biological heart valve prostheses, which can last 10 to 15 years.…”

Section: Introductionmentioning

confidence: 99%

Sterilization and Cross-Linking Combined with Ultraviolet Irradiation and Low-Energy Electron Irradiation Procedure: New Perspectives for Bovine Pericardial Implants in Cardiac Surgery

Walker

Dittfeld

Jakob

et al. 2020

Thorac Cardiovasc Surg

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Background Bovine pericardium is the major natural source of patches and aortic valve substitutes in cardiac repair procedures. However, long-term tissue durability and biocompatibility issues lead to degeneration (e.g., calcification) that requires reoperation. Tissue preparation strategies, including glutaraldehyde fixation, are reasons for the deterioration of pericardial tissues. We describe a pretreatment procedure involving sterilization and cross-linking combined with ultraviolet (UV) irradiation and low-energy electron irradiation (SULEEI). This innovative, glutaraldehyde-free protocol improves the mechanical aspects and biocompatibility of porcine pericardium patches. Methods We adopted the SULEEI protocol, which combines decellularization, sterilization, and cross-linking, along with UV irradiation and low-energy electron irradiation, to pretreat bovine pericardium. Biomechanics, such as ultimate tensile strength and elasticity, were investigated by comparing SULEEI-treated tissue with glutaraldehyde-fixed analogues, clinical patch materials, and an aortic valve substitute. Histomorphological and cellular aspects were investigated by histology, DNA content analysis, and degradability. Results Mechanical parameters, including ultimate tensile strength, elasticity (Young's modulus), and suture retention strength, were similar for SULEEI-treated and clinically applied bovine pericardium. The SULEEI-treated tissues showed well-preserved histoarchitecture that resembled all pericardial tissues investigated. Fiber density did not differ significantly. DNA content after the SULEEI procedure was reduced to less than 10% of the original tissue material, and more than 50% of the SULEEI-treated pericardium was digested by collagenase. Conclusion The SULEEI procedure represents a new treatment protocol for the preparation of patches and aortic valve prostheses from bovine pericardial tissue. The avoidance of glutaraldehyde fixation may lessen the tissue degeneration processes in cardiac repair patches and valve prostheses.

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Pericardial tissue for cardiovascular application: an in-vitro evaluation of established and advanced production processes

Cited by 12 publications

References 46 publications

Biological Characterization of Human Autologous Pericardium Treated with the Ozaki Procedure for Aortic Valve Reconstruction

Biological Characterization of Human Autologous Pericardium Treated with the Ozaki Procedure for Aortic Valve Reconstruction

Use of Pericardium for Cardiac Reconstruction Procedures in Acquired Heart Diseases—A Comprehensive Review

Sterilization and Cross-Linking Combined with Ultraviolet Irradiation and Low-Energy Electron Irradiation Procedure: New Perspectives for Bovine Pericardial Implants in Cardiac Surgery

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