TY - JOUR

T1 - Stabilizing A Vascularized Autologous Matrix with Flexible Magnesium Scaffolds to Reconstruct Dysfunctional Left Ventricular Myocardium in a Large-Animal Feasibility Study

AU - Schilling, Tobias

AU - Cebotari, Serghei

AU - Kaufeld, Tim

AU - Tudorache, Igor

AU - Brandes, Gudrun

AU - Hartung, Dagmar

AU - Wacker, Frank

AU - Bauer, Michael

AU - Haverich, Axel

AU - Hassel, Thomas

N1 - Funding Information: The excellent technical support of Klaus Höffler; Petra Ziehme; Astrid Dierks-Ketterkat; Rosi Katt of the Department of Cardiovascular, Thoracic, and Transplantation Surgery; as well as Astrid Österreich and Frank Schröder of the Institute for Radiology of Hannover Medical School is highly appreciated. We also thank Elke Mallon Institute of the Department of Cell Biology in the Center of Anatomy of Hannover Medical School for the valuable help in preparing the histologic specimens. We also thank Luigi Angrisani and Christoph Klose of the Institut für Werkstoffkunde (Materials Science) of Leibniz Universität Hannover for their support in the µ-CT investigations. We are grateful to Andre Bleich, Klaus Otto, Karl-Heinz Napierski, and Paul Zerbe of the Central animal facility of Hannover Medical School for their competent support in performing the animal surgery and providing excellent laboratory infrastructure. Finally, we thank the German Research Foundation (SFB599, project R7) for funding this project.

PY - 2023/1/29

Y1 - 2023/1/29

N2 - The surgical reconstruction of dysfunctional myocardium is necessary for patients with severe heart failure. Autologous biomaterials, such as vascularized patch materials, have a regenerative potential due to in vivo remodeling. However, additional temporary mechanical stabilization of the biomaterials is required to prevent aneurysms or rupture. Degradable magnesium scaffolds could prevent these life-threatening risks. A left ventricular transmural defect was reconstructed in minipigs with a piece of the autologous stomach. Geometrically adaptable and degradable scaffolds made of magnesium alloy LA63 were affixed on the epicardium to stabilize the stomach tissue. The degradation of the magnesium structures, their biocompatibility, physiological remodeling of the stomach, and the heart’s function were examined six months after the procedure via MRI (Magnetic Resonance Imaging), angiography, µ-CT, and light microscopy. All animals survived the surgery. Stable physiological integration of the stomach patch could be detected. No ruptures of the grafts occurred. The magnesium scaffolds showed good biocompatibility. Regenerative surgical approaches for treating severe heart failure are a promising therapeutic alternative to the currently available, far from optimal options. The temporary mechanical stabilization of viable, vascularized grafts facilitates their applicability in clinical scenarios.

AB - The surgical reconstruction of dysfunctional myocardium is necessary for patients with severe heart failure. Autologous biomaterials, such as vascularized patch materials, have a regenerative potential due to in vivo remodeling. However, additional temporary mechanical stabilization of the biomaterials is required to prevent aneurysms or rupture. Degradable magnesium scaffolds could prevent these life-threatening risks. A left ventricular transmural defect was reconstructed in minipigs with a piece of the autologous stomach. Geometrically adaptable and degradable scaffolds made of magnesium alloy LA63 were affixed on the epicardium to stabilize the stomach tissue. The degradation of the magnesium structures, their biocompatibility, physiological remodeling of the stomach, and the heart’s function were examined six months after the procedure via MRI (Magnetic Resonance Imaging), angiography, µ-CT, and light microscopy. All animals survived the surgery. Stable physiological integration of the stomach patch could be detected. No ruptures of the grafts occurred. The magnesium scaffolds showed good biocompatibility. Regenerative surgical approaches for treating severe heart failure are a promising therapeutic alternative to the currently available, far from optimal options. The temporary mechanical stabilization of viable, vascularized grafts facilitates their applicability in clinical scenarios.

KW - cardiac surgery

KW - magnesium degradation

KW - magnesium scaffold

KW - regenerative myocardial prostheses

KW - transmural left ventricular reconstruction

UR - http://www.scopus.com/inward/record.url?scp=85148858767&partnerID=8YFLogxK

U2 - 10.3390/jfb14020073

DO - 10.3390/jfb14020073

M3 - Article

AN - SCOPUS:85148858767

VL - 14

JO - Journal of Functional Biomaterials

JF - Journal of Functional Biomaterials

IS - 2

M1 - 73

ER -