Clinical experience with autologous endothelial cell-seeded polytetrafluoroethylene coronary artery bypass grafts.
OBJECTIVE
Autologous endothelial cell seeding was used to improve the patency of 4-mm polytetrafluoroethylene vascular prostheses.


METHODS
Since 1995, 14 patients with coronary artery disease received 21 autologous endothelial cell-seeded polytetrafluoroethylene vascular bypass grafts for coronary artery revascularization. The polytetrafluoroethylene grafts were seeded with the endothelial cells in a multiple step procedure, including cell culture techniques before coronary bypass operation. With the use of extracorporal circulation and cardioplegic arrest, a bypass operation was performed by means of conventional surgical techniques.


RESULTS
After a mean postoperative follow-up of 27.7 months (range, 7.5-48 months), the graft patency rate is 90.5%. Follow-up angiograms of the aorta-coronary polytetrafluoroethylene bypass grafts showed patent bypasses in all cases except two. Angiograms of all 19 patent endothelial cell-seeded polytetrafluoroethylene bypass grafts showed a smooth luminal borderline without stenotic regions. The percutaneous transluminal angioscopic evaluation showed a glossy white and smooth endoluminal graft surface without any fibrin, platelet, or erythrocyte deposits. Intravascular ultrasonographic examinations confirmed the results.


CONCLUSIONS
Patency of autologous endothelial cell-seeded 4-mm polytetrafluoroethylene vascular prostheses as coronary artery bypass grafts was much better than that of unseeded polytetrafluoroethylene grafts. Further evaluations and a larger population of patients will prove whether the encouraging patency will last.
Laube
H R
HR
Department of Cardiovascular Surgery, University Hospital Charité, Humboldt University Berlin, Germany. horst.laube@charite.de
Duwe
J
J
Rutsch
W
W
Konertz
W
W
D000368:Aged; D001807:Blood Vessel Prosthesis; D017690:Cell Transplantation; D001026:Coronary Artery Bypass; D004730:Endothelium, Vascular / Q000166:cytology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene
D011138:Polytetrafluoroethylene