Patient-specific tissue engineered vascular graft for aortic arch reconstructionCentral MessagePerspective
Hidenori Hayashi, MD,
Jacqueline Contento, BSE,
Hiroshi Matsushita, MD,
Paige Mass, MS,
Vincent Cleveland, MS,
Seda Aslan, MS,
Amartya Dave, BS,
Raquel dos Santos,
Angie Zhu,
Emmett Reid,
Tatsuya Watanabe, MD, PhD,
Nora Lee, MPAP, PA-C,
Tyler Dunn, BS,
Umar Siddiqi,
Katherine Nurminsky, BS,
Vivian Nguyen, BA,
Keigo Kawaji, PhD,
Joey Huddle, MS,
Luka Pocivavsek, MD, PhD,
Jed Johnson, PhD,
Mark Fuge, PhD,
Yue-Hin Loke, MD,
Axel Krieger, PhD,
Laura Olivieri, MD,
Narutoshi Hibino, MD, PhD
Affiliations
Hidenori Hayashi, MD
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Jacqueline Contento, BSE
Department of Cardiology, Children's National Hospital, Washington, DC
Hiroshi Matsushita, MD
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Paige Mass, MS
Department of Cardiology, Children's National Hospital, Washington, DC
Vincent Cleveland, MS
Department of Cardiology, Children's National Hospital, Washington, DC
Seda Aslan, MS
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Md
Amartya Dave, BS
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Raquel dos Santos
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Angie Zhu
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Emmett Reid
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Tatsuya Watanabe, MD, PhD
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Nora Lee, MPAP, PA-C
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Tyler Dunn, BS
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Umar Siddiqi
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Katherine Nurminsky, BS
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Vivian Nguyen, BA
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Ill
Keigo Kawaji, PhD
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Ill
Joey Huddle, MS
Nanofiber Solutions, LLC, Dublin, Ohio
Luka Pocivavsek, MD, PhD
Division of Vascular Surgery, Department of Surgery, University of Chicago, Chicago, Ill
Jed Johnson, PhD
Nanofiber Solutions, LLC, Dublin, Ohio
Mark Fuge, PhD
Department of Mechanical Engineering, University of Maryland, College Park, Md
Yue-Hin Loke, MD
Department of Cardiology, Children's National Hospital, Washington, DC
Axel Krieger, PhD
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Md
Laura Olivieri, MD
Department of Pediatric Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pa
Narutoshi Hibino, MD, PhD
Division of Cardiac Surgery, Department of Surgery, University of Chicago, Chicago, Ill; Department of Cardiovascular Surgery, Advocate Children's Hospital, Oak Lawn, Ill; Address for reprints: Narutoshi Hibino, MD, PhD, Division of Cardiac Surgery, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, Room E500B, MC5040, Chicago, IL 60637.
Objective(s): The complexity of aortic arch reconstruction due to diverse 3-dimensional geometrical abnormalities is a major challenge. This study introduces 3-dimensional printed tissue-engineered vascular grafts, which can fit patient-specific dimensions, optimize hemodynamics, exhibit antithrombotic and anti-infective properties, and accommodate growth. Methods: We procured cardiac magnetic resonance imaging with 4-dimensional flow for native porcine anatomy (n = 10), from which we designed tissue-engineered vascular grafts for the distal aortic arch, 4 weeks before surgery. An optimal shape of the curved vascular graft was designed using computer-aided design informed by computational fluid dynamics analysis. Grafts were manufactured and implanted into the distal aortic arch of porcine models, and postoperative cardiac magnetic resonance imaging data were collected. Pre- and postimplant hemodynamic data and histology were analyzed. Results: Postoperative magnetic resonance imaging of all pigs with 1:1 ratio of polycaprolactone and poly-L-lactide-co-ε-caprolactone demonstrated no specific dilatation or stenosis of the graft, revealing a positive growth trend in the graft area from the day after surgery to 3 months later, with maintaining a similar shape. The peak wall shear stress of the polycaprolactone/poly-L-lactide-co-ε-caprolactone graft portion did not change significantly between the day after surgery and 3 months later. Immunohistochemistry showed endothelization and smooth muscle layer formation without calcification of the polycaprolactone/poly-L-lactide-co-ε-caprolactone graft. Conclusions: Our patient-specific polycaprolactone/poly-L-lactide-co-ε-caprolactone tissue-engineered vascular grafts demonstrated optimal anatomical fit maintaining ideal hemodynamics and neotissue formation in a porcine model. This study provides a proof of concept of patient-specific tissue-engineered vascular grafts for aortic arch reconstruction.
