Tissue engineering of small caliber vascular grafts.
OBJECTIVE
Previous tissue engineering approaches to create small caliber vascular grafts have been limited by the structural and mechanical immaturity of the constructs. This study uses a novel in vitro pulse duplicator system providing a 'biomimetic' environment during tissue formation to yield more mature, implantable vascular grafts.


METHODS
Vascular grafts (I.D. 0.5 cm) were fabricated from novel bioabsorbable polymers (polyglycolic-acid/poly-4-hydroxybutyrate) and sequentially seeded with ovine vascular myofibroblasts and endothelial cells. After 4 days static culture, the grafts (n=24) were grown in vitro in a pulse duplicator system (bioreactor) for 4, 7, 14, 21, and 28 days. Controls (n=24) were grown in static culture conditions. Analysis of the neo-tissue included histology, scanning electron microscopy (SEM), and biochemical assays (DNA for cell content, 5-hydroxyproline for collagen). Mechanical testing was performed measuring the burst pressure and the suture retention strength.


RESULTS
Histology showed viable, dense tissue in all samples. SEM demonstrated confluent smooth inner surfaces of the grafts exposed to pulsatile flow after 14 days. Biochemical analysis revealed a continuous increase of cell mass and collagen to 21 days compared to significantly lower values in the static controls. The mechanical properties of the pulsed vascular grafts comprised supra-physiological burst strength and suture retention strength appropriate for surgical implantation.


CONCLUSIONS
This study demonstrates the feasibility of tissue engineering of viable, surgically implantable small caliber vascular grafts and the important effect of a 'biomimetic' in vitro environment on tissue maturation and extracellular matrix formation.
Hoerstrup
S P
SP
Clinic for Cardiovascular Surgery, University Hospital, Zürich, Switzerland. simon_philipp.hoerstrup@chi.usz.ch
Zünd
G
G
Sodian
R
R
Schnell
A M
AM
Grünenfelder
J
J
Turina
M I
MI
D020341:Absorbable Implants; D000818:Animals; D001807:Blood Vessel Prosthesis; D004730:Endothelium, Vascular / Q000166:cytology; D005347:Fibroblasts; D066298:In Vitro Techniques; D011474:Prosthesis Design; D011673:Pulsatile Flow; D012756:Sheep