Cellular coating of the left ventricular assist device textured polyurethane membrane reduces adhesion of Staphylococcus aureus Tomohiro Asai, MD, Mei-Ho.

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Cellular coating of the left ventricular assist device textured polyurethane membrane reduces adhesion of Staphylococcus aureus Tomohiro Asai, MD, Mei-Ho Lee, Carlos Arrecubieta, PhD, Manuel Prinz von Bayern, Christian A. Cespedes, Helen M. Baron, MD, Martin Cadeiras, MD, Taichi Sakaguchi, MD, Charles C. Marboe, MD, Yoshifumi Naka, MD, PhD, Mario C. Deng, MD, Franklin D. Lowy, MD The Journal of Thoracic and Cardiovascular Surgery Volume 133, Issue 5, Pages 1147-1153 (May 2007) DOI: 10.1016/j.jtcvs.2006.10.084 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Bacterial density on surface of polyurethane membrane 3 days after inoculation. A, Animals were inoculated with different concentrations of S aureus (106 and 107 colony-forming units [CFU]/mouse). B, Animals were infected days 1 and 14 after polyurethane patch implantation. pod, Postoperative day. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1147-1153DOI: (10.1016/j.jtcvs.2006.10.084) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Bacterial density in organs 3 days after infection with S aureus. A–C, Animals were inoculated with different concentrations of S aureus (106 and 107 colony-forming units [CFU]/mouse). D–F, Animals were infected days 1 and 14 after polyurethane patch implantation. pod, Postoperative day. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1147-1153DOI: (10.1016/j.jtcvs.2006.10.084) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Representative cross-section of aorta (Ao) 1 day after polyurethane patch (P) implantation, covered with thin fibrin (f) layer (hematoxylin-eosin staining, original magnification ×50). B, Representative cross-section of aorta (Ao) 4 days after polyurethane patch (P) implantation, covered with thick fibrin (f) layer. Animal was infected 1 day after implantation (hematoxylin-eosin staining, original magnification ×50) PMN, Polymorphonuclear cells. C, Cross-section obtained from same infected animal was Gram stained (107 colony-forming units, original magnification ×1000). Arrows indicate gram-positive cocci. P, Polyurethane patch. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1147-1153DOI: (10.1016/j.jtcvs.2006.10.084) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Hematoxylin-eosin staining of representative section of implanted polyurethane membrane (P) 1 day after implantation in aorta (Ao). Blood-contacting surface of polyurethane membrane is covered with thin layer of fibrin (f), and polymorphonuclear cells (PMN) are embedded with fibrin. Inserts show polymorphonuclear leukocytes. B, Hematoxylin-eosin staining of representative section of implanted polyurethane membrane (P) 14 days after implantation in aorta (Ao). Blood-contacting surface of polyurethane membrane is covered with cells. C, CD31 staining of representative section of implanted polyurethane membrane (P) 14 days after implantation in aorta (Ao) reveals cells on luminal surface to be CD31+ (arrows). This suggests that after 14 days polyurethane membrane has been covered with protective cell layer. These findings were consistent for all animals examined (n = 4 in each group; original magnification ×200). Insert shows 1000× magnification of CD31+ cells. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1147-1153DOI: (10.1016/j.jtcvs.2006.10.084) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 In vitro assay. Polyurethane membranes were fixed to 96-well tissue culture dishes and coated with fibrinogen. Half of membranes were subsequently coated with human endothelial cells and grown to confluence. Wb strain S aureus was added to wells, and adhesion assay was performed. CFU, Colony-forming units. The Journal of Thoracic and Cardiovascular Surgery 2007 133, 1147-1153DOI: (10.1016/j.jtcvs.2006.10.084) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions