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Long Term Efficacy and Fate of a Right Ventricular Outflow Tract Replacement Using a Novel Developed Material with Optimized Biodegradation and Elasticity

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Document pages: 34 pages

Abstract: For decades, researchers have investigated the ideal material for clinical use in the cardiovascular field. Several substitute materials are used clinically, but each has drawbacks. Recently we developed poly(e-caprolactone-co-D,L-lactide) (P(CL-DLLA)) polymers with optimized biodegradation and elasticity by adjusting the CL DLLA composition, and used these polymers in right ventricular outflow tract (RVOT) replacement to evaluate long-term efficacy and outcomes. This P(CL-DLLA) material was processed into a circular patch and used to replace a surgical defect in the RVOT of adult rats. Control rats were implanted with expanded polytetrafluoroethylene (ePTFE). Histologic evaluation was performed at 8, 24, and 48 weeks post-surgery. All animals survived the surgery with no aneurysm formation or thrombus. In all periods, ePTFE demonstrated fibrous tissue. In contrast, at 8 weeks P(CL-DLLA) showed infiltration of macrophages and fibroblast-like cells into the remaining material. At 24 weeks, P(CL-DLLA) was absorbed completely, and muscle-like tissue was present with positive staining for α-sarcomeric actinin and cTnT. At 48 weeks, the cTnT-positive area had increased. The P(CL-DLLA) with optimized elasticity and biodegradation induced cardiac regeneration throughout the 48-week study period. Future application of this material as a cardiovascular scaffold seems promising.

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