In vivo monitoring of function of autologous engineered pulmonary valve Danielle Gottlieb, MS, MD, MPH, Tandon Kunal, BS, Sitaram Emani, MD, Elena Aikawa,

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Presentation transcript:

In vivo monitoring of function of autologous engineered pulmonary valve Danielle Gottlieb, MS, MD, MPH, Tandon Kunal, BS, Sitaram Emani, MD, Elena Aikawa, MD, PhD, David W. Brown, MD, Andrew J. Powell, MD, Arthur Nedder, DVM, George C. Engelmayr, PhD, Juan M. Melero-Martin, PhD, Michael S. Sacks, PhD, John E. Mayer, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 3, Pages 723-731 (March 2010) DOI: 10.1016/j.jtcvs.2009.11.006 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Schematic representation of the study design. MRI, Magnetic resonance imaging. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 723-731DOI: (10.1016/j.jtcvs.2009.11.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Phase contrast micrograph (×10) of ovine mesenchymal stem cells. B, Assembled valve scaffold before seeding. C, Valved conduit after 1 month of in vitro culture, before implantation. D, Valved conduit mounted and sutured on tension device. E, Valve conduit after removal from tension device and before in vivo implantation. F, Implanted valved conduit. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 723-731DOI: (10.1016/j.jtcvs.2009.11.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Still echocardiographic image in diastole (A) and systole (B) after implantation. Magnetic resonance imaging long view (C) and short view (D) through leaflet cusps at 3 postoperative weeks, showing coapting leaflets in diastole (arrows). Flow image (E) and graphic representation (F) of flow velocities at 3 postoperative weeks showing no regurgitation (x-axis, time; y-axis, velocity [m/s]). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 723-731DOI: (10.1016/j.jtcvs.2009.11.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Measurements of smallest and largest conduit diameters by magnetic resonance imaging. B, Comparison of conduit diameter at time of explant with diameter measured by magnetic resonance imaging. C, Comparison of cusp length (dark circles) and width (open circles) over the study period. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 723-731DOI: (10.1016/j.jtcvs.2009.11.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Preimplant and explant tissue evaluation showing representative gross and histologic images at time points (A–C) before implant and after 1 (D–F), 6 (G–I), 12 (J–L), and 20 (M–O) weeks in vivo. Histologic images are stained with hematoxylin and eosin, photographed at ×20, and oriented with the cusp at the top and the conduit wall at the bottom of the image (C, cusp; S, sinus; W, conduit wall). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 723-731DOI: (10.1016/j.jtcvs.2009.11.006) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions