Novel Tissue-Engineered Biodegradable Material for Reconstruction of Vascular Wall Shigemitsu Iwai, MD, Yoshiki Sawa, MD, Satoshi Taketani, MD, Kei Torikai,

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Novel Tissue-Engineered Biodegradable Material for Reconstruction of Vascular Wall Shigemitsu Iwai, MD, Yoshiki Sawa, MD, Satoshi Taketani, MD, Kei Torikai, MD, Koichiro Hirakawa, MS, Hikaru Matsuda, MD The Annals of Thoracic Surgery Volume 80, Issue 5, Pages 1821-1827 (November 2005) DOI: 10.1016/j.athoracsur.2005.03.139 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Formation of a biodegradable scaffold reinforced with woven polylactic acid mesh (arrow) cross-linked with collagen-microsponge (A). Scanning electron microscopy image of the tissue-engineered patch shows the uniformly distributed and interconnected pore structure (pore size 50–150 μm) of the collagen-microsponge (B) (magnification 40×). The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The attachment and proliferation of seeded cells cultured on the polyglycolic acid (PGA) mesh with collagen-microsponge were significantly higher than when the culture was done on PGA mesh with a simple collagen-coat or on PGA mesh alone. * = p < 0.05 versus PGA mesh only; ** = p < 0.05 versus PGA mesh with collagen-coat and PGA mesh only; ♦ = PGA mesh only; ■ = PGA mesh with collagen-coat; ▴ = PGA mesh with collagen-microsponge. (MTT = 3-[4.5 dimethylthiazol 2-yl]-2,5-diphenyltetrazolium bromide.) The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Macroscopic and histologic findings of the descending aorta model, 2 months after implantation. Macroscopically, there was no aneurysm formation in any animal (A) and (B). The CD31 (C) and α-smooth muscle actin staining (D) showed uniform cellularization of the endothelial and smooth muscle cells (magnification 100×). The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Macroscopic (A and B) and histologic (C–E) findings of the pulmonary trunk model 1 month and 2 months after implantation. Macroscopically, there was no thrombus formation or neointimal thickness in any sample (A and B). Hematoxylin-eosin staining (C) (magnification 100×) showed in situ cellularization by 1 month (1 month [C]). The CD31 staining (D) (100×) showed a monolayer of endothelial cells by 1 month (1 month [D]). Alpha-smooth muscle actin staining (E) (100×) revealed the parallel alignment of smooth muscle cells at 2 months (2 months [E]). The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Right ventricular angiography of the large patch model. Arrow indicates tissue engineered patch. There was no stenosis or aneurysmal change from the right ventricular outflow tract to the pulmonary artery. The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Histologic and scanning electron microscopy findings of large tissue engineered patch (TEP) model 6 months after implantation. Hematoxylin-eosin staining (magnification 100×) showed that the architecture of the implanted TEP was similar to that of the native pulmonary artery wall (A). The scanning electron microscopy observations (500×) showed that the luminal surface of the TEP was uniformly covered by a confluent endothelium (B). Elastica van Gieson staining (100×) revealed the expansion of native tissue into the TEP (C). Factor VIII staining (100×) showed a number of microvessels in the regenerated tissue (D). The Annals of Thoracic Surgery 2005 80, 1821-1827DOI: (10.1016/j.athoracsur.2005.03.139) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions