Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model
Background Cardiovascular repair in children often requires implant of conduits which do not have growth potential and will require reoperation. In the current study we sought to determine the feasibility of catheter-based interventions of anisotropic conduits inserted as interposition grafts in the...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-11-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2020.1795324 |
| _version_ | 1797684567145971712 |
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| author | Anthony Azakie John P. Carney Matthew T. Lahti Melissa K. Seiberlich Gurumurthy Hiremath Yuriy Moklyak Richard W. Bianco |
| author_facet | Anthony Azakie John P. Carney Matthew T. Lahti Melissa K. Seiberlich Gurumurthy Hiremath Yuriy Moklyak Richard W. Bianco |
| author_sort | Anthony Azakie |
| collection | DOAJ |
| description | Background Cardiovascular repair in children often requires implant of conduits which do not have growth potential and will require reoperation. In the current study we sought to determine the feasibility of catheter-based interventions of anisotropic conduits inserted as interposition grafts in the main pulmonary artery (MPA) of growing lambs. Methods Lambs underwent interpositional implant of either an anisotropic expanded polytetrafluoroethylene (ePTFE) (Test) conduit or conventional PTFE (Control) conduit. In the postoperative period, lambs were anesthetized and underwent catheter-based interventions consisting of hemodynamic and angiographic data collection, balloon dilation and/or stenting of the conduit at 3, 6 or 9 month postoperative time point. Results At 3 months, control lambs showed significant increases in right ventricular pressures and trans-conduit gradients in comparison to test lambs. Test conduit diameters were significantly larger compared to controls due to spontaneous radial expansion of the anisotropic conduit. Balloon dilation of test conduits at 3 and 6 months showed a reduction in RV pressure and statistically significant improvement in the RV outflow tract gradient as well as significant increase in graft diameter, compared to both control and pre-dilation conditions. Furthermore, the test conduit diameter increased significantly compared to the pre-balloon and control conditions at each time point. Necropsy of test conduits showed no evidence of tears, perforations, or clot and smooth interiors with well-healed anastomoses. Conclusions Anisotropic conduits implanted as interposition grafts in the MPA show spontaneous expansion, and can safely and effectively undergo catheter-based interventions, with significant increases in graft diameter occurring after balloon dilation. |
| first_indexed | 2024-03-12T00:31:36Z |
| format | Article |
| id | doaj.art-cb11422bd5f04db1940bbba5764be664 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:31:36Z |
| publishDate | 2021-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-cb11422bd5f04db1940bbba5764be6642023-09-15T10:12:29ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-11-0134111231123710.1080/08941939.2020.17953241795324Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb ModelAnthony Azakie0John P. Carney1Matthew T. Lahti2Melissa K. Seiberlich3Gurumurthy Hiremath4Yuriy Moklyak5Richard W. Bianco6Experimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaExperimental Surgical Services Laboratory, Department of Surgery, University of MinnesotaBackground Cardiovascular repair in children often requires implant of conduits which do not have growth potential and will require reoperation. In the current study we sought to determine the feasibility of catheter-based interventions of anisotropic conduits inserted as interposition grafts in the main pulmonary artery (MPA) of growing lambs. Methods Lambs underwent interpositional implant of either an anisotropic expanded polytetrafluoroethylene (ePTFE) (Test) conduit or conventional PTFE (Control) conduit. In the postoperative period, lambs were anesthetized and underwent catheter-based interventions consisting of hemodynamic and angiographic data collection, balloon dilation and/or stenting of the conduit at 3, 6 or 9 month postoperative time point. Results At 3 months, control lambs showed significant increases in right ventricular pressures and trans-conduit gradients in comparison to test lambs. Test conduit diameters were significantly larger compared to controls due to spontaneous radial expansion of the anisotropic conduit. Balloon dilation of test conduits at 3 and 6 months showed a reduction in RV pressure and statistically significant improvement in the RV outflow tract gradient as well as significant increase in graft diameter, compared to both control and pre-dilation conditions. Furthermore, the test conduit diameter increased significantly compared to the pre-balloon and control conditions at each time point. Necropsy of test conduits showed no evidence of tears, perforations, or clot and smooth interiors with well-healed anastomoses. Conclusions Anisotropic conduits implanted as interposition grafts in the MPA show spontaneous expansion, and can safely and effectively undergo catheter-based interventions, with significant increases in graft diameter occurring after balloon dilation.http://dx.doi.org/10.1080/08941939.2020.1795324growing lamb modelconduitscongenital heart defectscardiac surgeryballoon dilationvalved stent |
| spellingShingle | Anthony Azakie John P. Carney Matthew T. Lahti Melissa K. Seiberlich Gurumurthy Hiremath Yuriy Moklyak Richard W. Bianco Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model Journal of Investigative Surgery growing lamb model conduits congenital heart defects cardiac surgery balloon dilation valved stent |
| title | Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model |
| title_full | Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model |
| title_fullStr | Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model |
| title_full_unstemmed | Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model |
| title_short | Feasibility Study of Catheter-Based Interventions for Anisotropic Expanded Polytetrafluoroethylene Cardiovascular Conduits in a Growing Lamb Model |
| title_sort | feasibility study of catheter based interventions for anisotropic expanded polytetrafluoroethylene cardiovascular conduits in a growing lamb model |
| topic | growing lamb model conduits congenital heart defects cardiac surgery balloon dilation valved stent |
| url | http://dx.doi.org/10.1080/08941939.2020.1795324 |
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