Newly Developed Tissue-Engineered Material for Reconstruction of Vascular Wall Without Cell Seeding Hiroaki Takahashi, MD, PhD, Takenori Yokota, MD,

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Newly Developed Tissue-Engineered Material for Reconstruction of Vascular Wall Without Cell Seeding Hiroaki Takahashi, MD, PhD, Takenori Yokota, MD, PhD, Eiichiro Uchimura, PhD, Shigeru Miyagawa, MD, PhD, Takeyoshi Ota, MD, PhD, Kei Torikai, MD, PhD, Atsuhiro Saito, PhD, Koichiro Hirakawa, MS, Katsukiyo Kitabayashi, MD, Kenji Okada, MD, PhD, Yoshiki Sawa, MD, PhD, Yutaka Okita, MD, PhD The Annals of Thoracic Surgery Volume 88, Issue 4, Pages 1269-1276 (October 2009) DOI: 10.1016/j.athoracsur.2009.04.087 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Scaffold design of polyglycolic acid (PGA)/poly-L-lactic acid (PLAA) patch (B) Intraoperative view of the tissue-engineered patch (arrow) implanted to the canine pulmonary arterial trunk. The Annals of Thoracic Surgery 2009 88, 1269-1276DOI: (10.1016/j.athoracsur.2009.04.087) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Macroscopic observation of the tissue-engineered patches 1 and 6 months after implantation. There were no sign of thrombus or aneurysmal formation in any animals at (A) 1 month or (B) 6 months. (C) Macroscopic findings of expanded polytetrafluoroethylene patches at 6 months showed that endothelial defects were always detected. (D) Scanning electron microscopy image (×1000) shows luminal surface of the tissue-engineered patch 1 month after implantation. The Annals of Thoracic Surgery 2009 88, 1269-1276DOI: (10.1016/j.athoracsur.2009.04.087) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The upper side of the photomicrograph shows the luminal surface. Double staining with hematoxylin-eosin and Victoria blue of the tissue-engineered patches showed the presence of elastic fibers at (A) 1, (B) 2, and (C) 6 months after implantation (asterisks). Double staining with von Willebrand factor and α-smooth muscle actin showed the surface of the tissue-engineered patches were completely covered with monolayer of endothelial cells at (E) 1, (F) 2 and (G) 6 months (arrows), and α-smooth muscle actin was distributed throughout the regenerative tissue (asterisks). (D, H) In contrast, the surface of the expanded polytetrafluoroethylene patches was covered with thin layer that was not stained. The scale bar represents 300 μm. The Annals of Thoracic Surgery 2009 88, 1269-1276DOI: (10.1016/j.athoracsur.2009.04.087) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Scanning electron micrographs of luminal surfaces of tissue-engineered patches 3 hours after implantation showed cell adhesion and complete coverage on the scaffold surfaces. (B) Images at 3 hours after implantation showed that fibrils were directly exposed to the lumen of expanded polytetrafluoroethylene without any endothelial coverage. The scale bar represents 50 μm. The Annals of Thoracic Surgery 2009 88, 1269-1276DOI: (10.1016/j.athoracsur.2009.04.087) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions