Industrial Processing Induces Pericardial Patch Degeneration
BackgroundAutologous pericardium is considered gold standard for various reconstructive surgical procedures in children. However, processed bovine, equine, and porcine pericardial tissue are also widely used. We investigated structural differences and analyzed alterations caused by industrial proces...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.881433/full |
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| author | Armin Darius Peivandi Sven Martens Barbara Heitplatz Alena Guseva Klaus-Michael Mueller Sabrina Martens |
| author_facet | Armin Darius Peivandi Sven Martens Barbara Heitplatz Alena Guseva Klaus-Michael Mueller Sabrina Martens |
| author_sort | Armin Darius Peivandi |
| collection | DOAJ |
| description | BackgroundAutologous pericardium is considered gold standard for various reconstructive surgical procedures in children. However, processed bovine, equine, and porcine pericardial tissue are also widely used. We investigated structural differences and analyzed alterations caused by industrial processing. Additionally human and equine pericardium explants, used during aortic valve reconstruction were analyzed.MethodsPericardial tissues (native, processed and explanted) were gathered and stained with HE and EvG to visualize collagen as well as elastic fibers. Fiber structures were visualized by light and polarization microscopy. Antibody staining against CD 3, CD 20, and CD 68 was performed to identify inflammation.ResultsNative pericardium of different species showed small differences in thickness, with bovine pericardium being the thickest [bovine: 390 μm (± 40.6 μm); porcine: 223 μm (± 30.1 μm); equine: 260 μm (± 28.4 μm)]. Juvenile pericardium was 277 μm (± 26.7 μm). Single collagen bundle diameter displayed variations (~3–20 μm). Parallel collagen fibers were densely packed with small inter-fibrillary space. After industrial tissue processing, loosening of collagen network with inter-fibrillary gapping was observed. Pericardium appeared thicker (mean values ranging from 257–670 μm). Processed tissue showed less birefringence under polarized light. All analyzed tissues showed a small number of elastic fibers. Fibrosis, calcification and inflammatory processes of autologous and equine pericardium were observed in patient explants.ConclusionNone of the analyzed tissues resembled the exact structure of the autologous pericardial explant. Degeneration of pericardium starts during industrial processing, suggesting a potential harm on graft longevity in children. A careful surgical approach prior to the implantation of xenografts is therefore needed. |
| first_indexed | 2024-04-12T11:14:43Z |
| format | Article |
| id | doaj.art-76d7900a11a244e9b2d137985a536e51 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T11:14:43Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-76d7900a11a244e9b2d137985a536e512022-12-22T03:35:32ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-05-01910.3389/fsurg.2022.881433881433Industrial Processing Induces Pericardial Patch DegenerationArmin Darius Peivandi0Sven Martens1Barbara Heitplatz2Alena Guseva3Klaus-Michael Mueller4Sabrina Martens5Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyGerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyGerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyBackgroundAutologous pericardium is considered gold standard for various reconstructive surgical procedures in children. However, processed bovine, equine, and porcine pericardial tissue are also widely used. We investigated structural differences and analyzed alterations caused by industrial processing. Additionally human and equine pericardium explants, used during aortic valve reconstruction were analyzed.MethodsPericardial tissues (native, processed and explanted) were gathered and stained with HE and EvG to visualize collagen as well as elastic fibers. Fiber structures were visualized by light and polarization microscopy. Antibody staining against CD 3, CD 20, and CD 68 was performed to identify inflammation.ResultsNative pericardium of different species showed small differences in thickness, with bovine pericardium being the thickest [bovine: 390 μm (± 40.6 μm); porcine: 223 μm (± 30.1 μm); equine: 260 μm (± 28.4 μm)]. Juvenile pericardium was 277 μm (± 26.7 μm). Single collagen bundle diameter displayed variations (~3–20 μm). Parallel collagen fibers were densely packed with small inter-fibrillary space. After industrial tissue processing, loosening of collagen network with inter-fibrillary gapping was observed. Pericardium appeared thicker (mean values ranging from 257–670 μm). Processed tissue showed less birefringence under polarized light. All analyzed tissues showed a small number of elastic fibers. Fibrosis, calcification and inflammatory processes of autologous and equine pericardium were observed in patient explants.ConclusionNone of the analyzed tissues resembled the exact structure of the autologous pericardial explant. Degeneration of pericardium starts during industrial processing, suggesting a potential harm on graft longevity in children. A careful surgical approach prior to the implantation of xenografts is therefore needed.https://www.frontiersin.org/articles/10.3389/fsurg.2022.881433/fullcongenital heart surgerypatcheshistopathologydegenerationindustrial processing |
| spellingShingle | Armin Darius Peivandi Sven Martens Barbara Heitplatz Alena Guseva Klaus-Michael Mueller Sabrina Martens Industrial Processing Induces Pericardial Patch Degeneration Frontiers in Surgery congenital heart surgery patches histopathology degeneration industrial processing |
| title | Industrial Processing Induces Pericardial Patch Degeneration |
| title_full | Industrial Processing Induces Pericardial Patch Degeneration |
| title_fullStr | Industrial Processing Induces Pericardial Patch Degeneration |
| title_full_unstemmed | Industrial Processing Induces Pericardial Patch Degeneration |
| title_short | Industrial Processing Induces Pericardial Patch Degeneration |
| title_sort | industrial processing induces pericardial patch degeneration |
| topic | congenital heart surgery patches histopathology degeneration industrial processing |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.881433/full |
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