Urinary Bladder Matrix Scaffolds Promote Pericardium Repair in a Porcine Model
Urinary Bladder Matrix Scaffolds Promote Pericardium Repair in a Porcine Model
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DOI：
10.1016/j.jss.2019.12.033
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发表时间：
2020-05-01
影响因子：
2.2
通讯作者：
Nieponice, Alejandro
中科院分区：
文献类型：
--
作者：
Amigo, Natalia;Martin Riganti, Juan;Nieponice, Alejandro
建议在心脏手术后关闭胸骨后间隙，以防止术后粘连至胸骨。合成材料已被用作替代品，但由于重塑受损和纤维化组织形成，结果有限。膀胱基质（UBM）支架促进更接近天然组织的建设性重塑。本研究的目的是评估宿主对部分心包切除术的猪模型中UBM支架的反应。对12头长白猪进行正中胸骨切开术。创建一个5 x 7 cm的心包缺损，然后用5 x 7 cm的多层UBM补片（UBM组）闭合或作为开放缺损（对照组）保留。动物存活8周。终点包括大体形态学、生物力学测试、组织学半定量评分和心功能。UBM组显示轻度粘连，而对照组在修复部位显示纤维化，冠状动脉床有牢固的粘连和损伤。与自体心包相比，UBM组的失效载荷（gr）和刚度（gr/mm）较低（分别为199.9 +/- 59.2 vs 405.3 +/- 99.89 g，P = 0.0536和44.23 +/- 15.01 vs 146.5 +/- 24.38 g/mm，P = 0.0025）。在UBM组中，组织学类似于天然心包组织，具有新血管形成、新成纤维细胞和很少的炎症体征。相比之下，对照组显示纤维化组织伴单核细胞浸润，缺乏组织化胶原纤维，经组织学评分验证。两组超声检查结果均正常，无心脏动力障碍。在这种情况下，UBM支架显示出适合心包修复的特征，恢复组织特性，有助于减少术后粘连并预防相关并发症。(C)2020爱思唯尔公司All rights reserved.
Pericardium closure after cardiac surgery is recommended to prevent postoperative adhesions to the sternum. Synthetic materials have been used as substitutes, with limited results because of impaired remodeling and fibrotic tissue formation. Urinary bladder matrix (UBM) scaffolds promote constructive remodeling that more closely resemble the native tissue. The aim of the study is to evaluate the host response to UBM scaffolds in a porcine model of partial pericardial resection. Twelve Landrace pigs were subjected to a median sternotomy. A 5 x 7 cm pericardial defect was created and then closed with a 5 x 7 cm multilayer UBM patch (UBM group) or left as an open defect (control group). Animals were survived for 8 wk. End points included gross morphology, biomechanical testing, histology with semiquantitative score, and cardiac function. The UBM group showed mild adhesions, whereas the control group showed fibrosis at the repair site, with robust adhesions and injury to the coronary bed. Load at failure (gr) and stiffness (gr/mm) were lower in the UBM group compared with the native pericardium (199.9 +/- 59.2 versus 405.3 +/- 99.89 g, P = 0.0536 and 44.23 +/- 15.01 versus 146.5 +/- 24.38 g/mm, P = 0.0025, respectively). In the UBM group, the histology resembled native pericardial tissue, with neovascularization, neofibroblasts, and little inflammatory signs. In contrast, control group showed fibrotic tissue with mononuclear infiltrates and a lack of organized collagen fibers validated with a histologic score. Both groups had normal ultrasonography results without cardiac motility disorders. In this setting, UBM scaffolds showed appropriate features for pericardial repair, restoring tissue properties that could help reduce postsurgical adhesions and prevent its associated complications. (C) 2020 Elsevier Inc. All rights reserved.