Abstract 14477: Medial Regeneration Using a Biodegradable Felt as a Scaffold Preserves Integrity and Compliance of a Canine Dissected Aorta
Background: Repair of a dissected aorta consists of reattachment of the media with synthetic glue and/or reinforcement with a non-biodegradable felt. There have been reported late complications specific to each aspect of this reparative procedure. Our experimental approach represents an attempt to regenerate the media by using a biodegradable felt.
Methods: We created a canine model of descending thoracic aortic dissection, and we employed four different modalities for aortic repair: biodegradable polyglycolic acid (PGA) felt in the media; PGA with basic fibroblast growth factor (bFGF) in the media; PGA with bFGF in the media plus external reinforcement with an expanded polytetrafluoroethylene; and primary suture closure of the dissected lumen (control). To assess the strength of the repaired aortic stumps, we performed quantitative tensile test of suture pull-out strength. In addition, animals were kept alive and histological changes along with compliance tests were examined 6 months after the repair.
Results: Failure force improved by four folds in all the three medial reinforcement groups compared with control. Compliance of the aortic wall at the anastomotic sites was not essentially affected at long term except in the group with concomitant external reinforcement (55.9±4.5 % reduction, p<0.05, see figures). Elastic fiber in the media, collagen fiber in the adventitia along with vessel density both in the repaired false lumen and the adventitia significantly decreased in the group with external reinforcement, while histological derangement was not observed in control or medial reinforcement groups. Basic FGF, when applied with PGA in dissected lumen, failed to yield additional modifications in this animal model.
Conclusions: Medial reinforcement provides augmented strength sufficient for aortic surgical repair. Medial regeneration using a biodegradable felt as a scaffold preserves histological integrity and compliance of a canine dissected aorta.
- © 2011 by American Heart Association, Inc.