Midterm clinical result of tissue-engineered vascular autografts seeded with autologous bone marrow cells Toshiharu Shin’oka, MD, PhD, Goki Matsumura,

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Presentation transcript:

Midterm clinical result of tissue-engineered vascular autografts seeded with autologous bone marrow cells Toshiharu Shin’oka, MD, PhD, Goki Matsumura, MD, PhD, Narutoshi Hibino, MD, Yuji Naito, MD, Manabu Watanabe, MD, Takeshi Konuma, MD, Takahiko Sakamoto, MD, PhD, Masayoshi Nagatsu, MD, PhD, Hiromi Kurosawa, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 129, Issue 6, Pages 1330-1338 (June 2005) DOI: 10.1016/j.jtcvs.2004.12.047 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Macroscopic finding of biodegradable scaffolds and scanning electromicroscopic findings of polymer scaffolds. Upper left, Macroscopic finding; 18 mm in diameter.Copolymer of l-lactide and ϵ-caprolactone synthesized by ring-opening polymerization, with weight composition ratio of l-lactide and ϵ-caprolactone at 50:50. Polymeric woven scaffold composed of polycaprolactum and polylactic acid reinforced with PGA mesh. Bars represent 200 μm (middle left), 100 μm (lower left, upper right), and 50 μm (middle right, lower right). The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Histopathologic findings on explanted patch in patient with reoperation. Arrows indicate endothelium-like cells. A, Hematoxylin-eosin stain, original magnification ×400; B, Masson stain, original magnification ×400; C, Victoria blue, original magnification ×400; D, hematoxylin-eosin stain, original magnification ×800. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Pulmonary angiograms of patient 31. A, Lateral view of pulmonary angiogram before operation showed peripheral stenosis (white arrowhead) with aneurysmal formation (white arrow) after balloon angioplasty. B, Same view 6 months after operation. White arrows indicate location of tissue-engineered patch. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Magnetic resonance image 9 months after implantation of TCPC graft (patient 8). White arrow indicates location of tissue-engineered conduit. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Measurements of major and minor axes of tissue-engineered grafts in patients 2 (A), 4 (B), and 12 (C). Upper row, Anteroposterior view; lower row, lateral view. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Percentage changes in cross-sectional area of tissue-engineered grafts 1 year after operation. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Scanning electromicroscopic findings of seeded BMCs on polymer scaffold. Bar represents 50 μm. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Histologic findings of seeded polymer. A, Mononuclear cells in scaffold (May-Grünwald-Giemsa staining). B, Immunohistochemical staining for CD34 showed positive cells in scaffold (arrows). The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Postoperative maximum values of C-reactive protein (max CRP) and white blood cell count (max WBC) showed no significant difference between groups. TE, Group implanted with tissue-engineered graft. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Three-dimensional computed tomographic image 12 months after implantation of TCPC graft (patient 20). Red arrow indicates location of tissue-engineered conduit. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1330-1338DOI: (10.1016/j.jtcvs.2004.12.047) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions