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J Thorac Cardiovasc Surg 2006;132:867-874
© 2006 The American Association for Thoracic Surgery

Evolving Technology

Mesothelium regeneration on acellular bovine pericardia loaded with an angiogenic agent (ginsenoside Rg1) successfully reduces postsurgical pericardial adhesions

Yen Chang, MDa, Po-Hong Lai, MSb, Chung-Chi Wang, MDa, Sung-Ching Chen, PhDb, Wei-Chun Chang, MSb, Hsing-Wen Sung, PhDb,*

a Division of Cardiovascular Surgery, Veterans General Hospital-Taichung and the College of Medicine, National Yang-Ming University, Taipei, Taiwan
b Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan.

Received for publication April 26, 2006; revisions received June 5, 2006; accepted for publication June 13, 2006.

* Address for reprints: Hsing-Wen Sung, PhD, Biological Engineering Center, Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan 30013. (Email: hwsung{at}che.nthu.edu.tw).

Objective: Our objective was to reduce postsurgical pericardial adhesions with porous acellular bovine pericardia loaded with ginsenoside Rg1, an angiogenic agent isolated from Panax ginseng (the Acellular/Rg1 patch).

Methods: The acellular/Rg1 patch was used as a substitute to repair a defect created in the pericardium of a rabbit model. A commercially available expanded polytetrafluoroethylene patch, the cellular pericardium (the cellular patch), and the acellular pericardium without loading Rg1 (the acellular patch) were used as controls. The implanted samples were retrieved at 1 and 3 months after surgery (n = 5 per group at each time point).

Results: It was found that each side of the implanted patch could be remesothelialized provided that regeneration of neo–tissue fibrils occurred initially on its surfaces. Because remesothelialization did not take place on the surfaces of the expanded polytetrafluoroethylene and cellular patches, moderate to severe adhesions to the lung and epicardium were clearly observed. As compared with the cellular patch, the acellular patch significantly reduced postsurgical pericardial adhesions, especially on its lung side, as a result of remesothelialization. In the presence of Rg1, a faster remesothelialization was observed on each side of the acellular/Rg1 patch. Therefore, the acellular/Rg1 patch was free of any adhesions to the lung; however, there was still a filmy adhesion to the epicardium observed in 3 of the 5 studied animals at 3 months after surgery, due to incomplete remesothelialization.

Conclusions: The acellular/Rg1 patch effectively repaired pericardial defects in rabbits and successfully reduced the formation of pericardial adhesions.

Abbreviations and Acronyms ECM = extracellular matrix; e-PTFE = expanded polytetrafluoroethylene




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