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Efficacy of silver-coated poly(ethylene terephthalate) to prevent bacterial attachment and subsequent infection was quantified in vitro, in both batch- and flowing-fluid experiments. Kinetic analysis of batch suspended cell cultures of Staphylococcus epidermidis (SE), at various growth-limiting nutrient concentrations, in the absence of any fabric, indicated a maximum culture growth rate constant micro(max) = 0.78 +/- 0.02 h(-1). Batch experiments for Control fabric samples indicated that SE cultures exhibited about the same suspended cell growth rate (0.72 +/- 0.02 h(-1)) as observed in batch suspended cultures without fabric. Suspended SE cultures in the presence of silver-coated fabric grew at a considerably lower rate, 0.15 +/- 0.01 h(-1), indicating the inhibitory effect of Ag(+2) ion released from the fabric. Growth rates of suspended SE cultures were 5-6 times higher in the fluid phase in contact with the Control fabric compared to cultures exposed to silver-coated fabric. Maximum suspended cell concentrations attained at time = 24 h were 1-2 orders of magnitude higher for Control fabrics vs. silver-coated fabric. In all batch colonization experiments, both live and dead SE bacterial cells accumulate on the surfaces of both silver-coated and Control fabrics. Adherent viable SE cells accumulated to 1-2 orders of magnitude more ( approximately 5 x 10(+8) cells/cm(2)) on Control fabric than SE cells on the silver-coated fabric ( approximately 1.1 x 10(+6) cells/cm(2)), respectively. Between 70-95% SE cells on the Control fabric were viable, while on the silver-coated fabric samples, at 24 h, viable cells were less than 10% of the adherent community (i.e., greater than 90% nonviable cells). In flow cell colonization experiments, SE cells accumulated on Control fabric to a maximum adherent cell concentration of 6 x 10(+7) - 8 x 10(+7) cells/cm(2) by 24 h with the proportion of viable cells remaining relatively constant at 76% throughout an experiment. Both noninvasive microscopic enumeration and destructive assays gave the same results for adherent cell numbers. Using silver-coated fabric, total cells numbers (live + dead) reached a level of approximately 1.1 x 10(+7) - 3.0 x 10(+7) cells/cm(2) after about 6 h and remained constant. However, while the proportion of viable cells initially on the surface was 63-75%, this fraction dropped continuously during each experiment to less than 6% viable cells at 24 h. Regardless of the criteria, the number of viable or nonviable cells attached to silver-coated fabric were significantly lower than on Control fabric.
Efficacy of silver-coated poly(ethylene terephthalate) to prevent bacterial attachment and subsequent infection was quantified in vitro, in both batch- and flowing-fluid experiments. Kinetic analysis of batch suspended cell cultures of Staphylococcus epidermidis (SE), at various growth-limiting nutrient concentrations, in the absence of any fabric, indicated a maximum culture growth rate constant micro(max) = 0.78 +/- 0.02 h(-1). Batch experiments for Control fabric samples indicated that SE cultures exhibited about the same suspended cell growth rate (0.72 +/- 0.02 h(-1)) as observed in batch suspended cultures without fabric. Suspended SE cultures in the presence of silver-coated fabric grew at a considerably lower rate, 0.15 +/- 0.01 h(-1), indicating the inhibitory effect of Ag(+2) ion released from the fabric. Growth rates of suspended SE cultures were 5-6 times higher in the fluid phase in contact with the Control fabric compared to cultures exposed to silver-coated fabric. Maximum suspended cell concentrations attained at time = 24 h were 1-2 orders of magnitude higher for Control fabrics vs. silver-coated fabric. In all batch colonization experiments, both live and dead SE bacterial cells accumulate on the surfaces of both silver-coated and Control fabrics. Adherent viable SE cells accumulated to 1-2 orders of magnitude more ( approximately 5 x 10(+8) cells/cm(2)) on Control fabric than SE cells on the silver-coated fabric ( approximately 1.1 x 10(+6) cells/cm(2)), respectively. Between 70-95% SE cells on the Control fabric were viable, while on the silver-coated fabric samples, at 24 h, viable cells were less than 10% of the adherent community (i.e., greater than 90% nonviable cells). In flow cell colonization experiments, SE cells accumulated on Control fabric to a maximum adherent cell concentration of 6 x 10(+7) - 8 x 10(+7) cells/cm(2) by 24 h with the proportion of viable cells remaining relatively constant at 76% throughout an experiment. Both noninvasive microscopic enumeration and destructive assays gave the same results for adherent cell numbers. Using silver-coated fabric, total cells numbers (live + dead) reached a level of approximately 1.1 x 10(+7) - 3.0 x 10(+7) cells/cm(2) after about 6 h and remained constant. However, while the proportion of viable cells initially on the surface was 63-75%, this fraction dropped continuously during each experiment to less than 6% viable cells at 24 h. Regardless of the criteria, the number of viable or nonviable cells attached to silver-coated fabric were significantly lower than on Control fabric.
Infants and children born with severe cardiac valve lesions have no effective long term treatment options since currently available tissue or mechanical prosthetic valves have sizing limitations and no avenue to accommodate the growth of the pediatric patient. Tissue engineered heart valves (TEHVs) which could provide for growth, self-repair, infection resistance, and long-term replacement could be an ideal solution. Porcine small intestinal submucosa (PSIS) has recently emerged as a potentially attractive bioscaffold for TEHVs. PSIS may possess the ability to recruit endogenous cardiovascular cells, leading to phenotypically-matched replacement tissue when the scaffold has completely degraded. Our group has successfully implanted custom-made PSIS valves in 4 infants with critical valve defects in whom standard bioprosthetic or mechanical valves were not an option. Short term clinical follow-up has been promising. However, no hydrodynamic data has been reported to date on these valves. The purpose of this study was to assess the functional effectiveness of tri-leaflet PSIS bioscaffolds in the aortic position compared to standard tri-leaflet porcine bioprosthetic valves. Hydrodynamic evaluation of acute PSIS function was conducted using a left heart simulator in our laboratory. Our results demonstrated similar flow and pressure profiles (p > 0.05) between the PSIS valves and the control valves. However, forward flow energy losses were found to be significantly greater (p < 0.05) in the PSIS valves compared to the controls possibly as a result of stiffer material properties of PSIS relative to glutaraldehyde-fixed porcine valve tissue. Our findings suggest that optimization of valve dimensions and shape may be important in accelerating de novo valve tissue growth and avoidance of long-term complications associated with higher energy losses (e.g. left ventricular hypertrophy). Furthermore, long term animal and clinical studies will be needed in order to conclusively address somatic growth potential of PSIS valves.
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