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J Thorac Cardiovasc Surg 2008;136:900-907
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

In situ tissue regeneration using a novel tissue-engineered, small-caliber vascular graft without cell seeding

Takenori Yokota, MDa, Hajime Ichikawa, MD, PhDa, Goro Matsumiya, MD, PhDa, Toru Kuratani, MD, PhDa, Taichi Sakaguchi, MD, PhDa, Shigemitsu Iwai, MD, PhDa, Yukitoshi Shirakawa, MD, PhDa, Kei Torikai, MD, PhDa, Atsuhiro Saito, PhDa, Eiichiro Uchimura, PhDa, Naomasa Kawaguchi, PhDb, Nariaki Matsuura, MD, PhDb, Yoshiki Sawa, MD, PhDa,*

a Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
b Department of Pathology, Osaka University School of Allied Health Science, Osaka, Japan

Received for publication November 13, 2007; revisions received January 7, 2008; accepted for publication February 4, 2008.

* Address for reprints: Yoshiki Sawa, MD, PhD, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan. (Email: sawa{at}surg1.med.osaka-u.ac.jp).

Objective: Various types of natural and synthetic scaffolds with arterial tissue cells or differentiated stem cells have recently attracted interest as potential small-caliber vascular grafts. It was thought that the synthetic graft with the potential to promote autologous tissue regeneration without any seeding would be more practical than a seeded graft. In this study, we investigated in situ tissue regeneration in small-diameter arteries using a novel tissue-engineered biodegradable vascular graft that did not require ex vivo cell seeding.

Methods: Small-caliber vascular grafts (4 mm in diameter) were fabricated by compounding a collagen microsponge with a biodegradable woven polymer tube that was constructed in a plain weave pattern with a double layer of polyglycolic acid (core) and poly-L-lactic acid (sheath) fibers. We implanted these tissue-engineered vascular grafts bilaterally into the carotid arteries of mongrel dogs (body weight, 20–25 kg). No anticoagulation regimen was used after implantation. We sacrificed the dogs 2, 4, 6, and 12 months (n = 4 in each group) after implantation and evaluated the explants histologically and biochemically.

Results: All of the tissue-engineered vascular grafts were patent with no signs of thrombosis or aneurysm at any time. Histologic and biochemical examinations showed excellent in situ tissue regeneration with an endothelial cell monolayer, smooth muscle cells, and a reconstructed vessel wall with elastin and collagen fibers.

Conclusion: Our study indicated that this novel tissue-engineered vascular graft promoted in situ tissue regeneration and did not require ex vivo cell seeding, thereby conferring better patency on small-caliber vascular prostheses.

Abbreviations and Acronyms ECM = extracellular matrix; ePTFE = expanded polytetrafluoroethylene; PGA = polyglycolic acid; PLLA = poly-L-lactic acid; TEVG = tissue-engineered vascular graft






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