Asian Cardiovascular and Thoracic Annals http://aan.sagepub.com/
Crosslinked acellular saphenous vein for small-diameter vascular graft Balasundari Ramesh, Santosh Mathapati, Satish Galla, Kotturathu Mammen Cherian and Soma Guhathakurta Asian Cardiovascular and Thoracic Annals 2013 21: 293 DOI: 10.1177/0218492312454019 The online version of this article can be found at: http://aan.sagepub.com/content/21/3/293
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Original Article
Crosslinked acellular saphenous vein for small-diameter vascular graft
Asian Cardiovascular & Thoracic Annals 21(3) 293–302 ß The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492312454019 aan.sagepub.com
Balasundari Ramesh1, Santosh Mathapati1, Satish Galla1, Kotturathu Mammen Cherian1 and Soma Guhathakurta2
Abstract Objective: Patients with congenital and acquired heart diseases or arteriopathy require small-diameter vascular grafts for arterial reconstruction. Autologous veins are the most suitable graft, but when absent, an alternative is necessary. This work addresses the issue. Background: Tissue-engineering efforts to create such grafts by modifications of acellular natural scaffolds are considered a promising area. Methods: Homologous saphenous veins harvested from cadavers and organ donors were processed by decellularization with detergent and enzymatic digestion, followed by crosslinking by dye-mediated photooxidation. They were validated for acellularity, mechanical strength, and crosslink stability. In-vitro and in-vivo cytotoxicity and hemocompatibility studies were conducted. Collagen conformity was studied by Fourier transform infrared spectroscopy, and heat stability by differential scanning calorimetry. A limited large animal study was performed. Results: The processing method delivered biocompatible, hemocompatible, effectively crosslinked grafts, with high heat stability of 126 C, an enthalpy value of 183.5 Jg1, and collagen conformity close to that of the native vein. The mechanical strength was 250% better than the native vein. The presence of extracellular matrix proteins allowed the acellular vein to become a triple-layered vascular structure in the sheep venous system. Conclusion: Crosslinking after decellularization by the dye-mediated photooxidation method could be reproduced in any human vein to obtain a small-diameter vascular grafts.
Keywords Biocompatible materials, blood vessel prosthesis, materials testing, saphenous vein, vascular diseases
Introduction The small-diameter vascular grafts (SDVG) currently used in clinical practice have limitations due to restricted availability and the secondary morbidity of autologous vein harvested, lifelong anticoagulation (synthetic), neointimal proliferation, and aneurysm formation. The various forms used are arterial and venous autografts, allografts, xenografts, alloplastic prostheses, and tissue-engineered products. Synthetic vascular grafts