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European Journal of Cardio-thoracic... Apr 2014Autologous pericardium rapidly fixed with glutaraldehyde (GA) in theatre is considered in many cardiac surgery centres the best material currently available for...
Biostability, durability and calcification of cryopreserved human pericardium after rapid glutaraldehyde-stabilization versus multistep ADAPT(R) treatment in a subcutaneous rat model.
OBJECTIVES
Autologous pericardium rapidly fixed with glutaraldehyde (GA) in theatre is considered in many cardiac surgery centres the best material currently available for intracardiac, valvular or vascular repair. Implanted non-fixed autologous tissues suffer rapid degeneration, shrinkage and absorption whereas standard xenotypic fixed tissues cause local cytotoxicity and calcification. In the present study, using a subcutaneous rat model, we tested the biostability, durability and calcification potential of four different pericardium patches treated with GA and relevant to current clinical practice.
METHODS
Pericardium samples were divided into four groups according to the method of treatment. Group I consisted of bovine pericardium (BP) fixed with 0.6% GA (control), Group II cryopreserved human pericardium (CHP) rapidly fixed with 0.6% GA for 4 min and detoxified with MgCl2, Group III CHP treated with the multistep ADAPT(®) process (delipidized, decellularized with Tx-100, deoxycholate, IgePal CA-630 and denucleased, fixed in 0.05% monomeric GA and detoxified) and Group IV BP treated with the multistep ADAPT(®) process (CardioCel(®)). Biostability was determined by shrinkage temperature which measures the degree of cross-linking, and durability assessed by resistance to a mixture of proteinases (pronase digestion). Treated pericardium samples (n = 10 in each of Groups I-IV) were implanted in the subcutaneous rat model for 8 and 16 weeks, followed by histology and calcium analysis (atomic absorption spectrophotometry).
RESULTS
The biostability and the durability of both CHP and BP after the multistep ADAPT(®) treatment remained stable without any microscopic calcification. Extractable calcium levels of CHP were significantly (P < 0.01) reduced in Group II (1.89 ± 0.77 μg Ca/mg tissue) compared with Group I (64.37 ± 6.25 μg/mg) after 8 weeks. Calcification of CHP (Group III) and BP (Group IV) after the multistep ADAPT(®) treatment was significantly reduced (1.43 ± 0.48 µg/mg and 0.75 ± 0.10 μg/mg, respectively) compared with Group I (282.52 ± 18.26 μg/mg) and the rapidly treated CHP in Group II (11.32 ± 3.21 μg/mg) after 16 weeks.
CONCLUSIONS
Improved biostability and durability with reduced calcification of tissues after the multistep ADAPT(®) tissue treatment suggest improved alternative substitutes to autologous pericardium.
Topics: Analysis of Variance; Animals; Calcinosis; Calcium; Cattle; Cryopreservation; Glutaral; Humans; Male; Materials Testing; Microscopy; Pericardium; Rats; Rats, Wistar
PubMed: 24431173
DOI: 10.1093/ejcts/ezt623 -
Cardiologia (Rome, Italy) Aug 1989
Review
Topics: Animals; Dogs; Humans; Pericardial Effusion; Pericardium; Systole; Ventricular Function
PubMed: 2691075
DOI: No ID Found -
Journal of Anatomy Jun 1984The ultrastructure of the parietal pericardium in Melanogrammus aeglefinus, Paracheirodon innesi, and Poecilia reticulata is described in larvae of variable age. This...
The ultrastructure of the parietal pericardium in Melanogrammus aeglefinus, Paracheirodon innesi, and Poecilia reticulata is described in larvae of variable age. This structure is composed of a mesothelial layer facing the pericardial cavity and an outer layer of collagen tissue. The latter is continuous with the surrounding tissue, i.e. mainly skeletal muscles. Generally, the parietal pericardium is attached to loose connective tissue dorsally, whereas its ventral and lateral parts are connected to muscles and tendons. Posteriorly, it is fused with the peritoneum. In prenatal larvae of P. reticulata the parietal pericardium is in contact with yolk material. The parietal mesothelial cells are attenuated and contain numerous ribosomes, a well developed Golgi apparatus, and a number of membrane-bound inclusion bodies (0.1-0.4 micron) of moderate electron density. In addition, numerous pinocytotic vesicles (80-100 nm) occur in differentiated mesothelial cells, whereas they are scarce in undifferentiated cells. Furthermore, bristle-coated vesicles are very rare in differentiated mesothelial cells, whereas they are seen regularly in undifferentiated cells. The collagen fibre bundles of the parietal pericardium are often orientated perpendicularly to each other, and in postnatal larvae of P. reticulata a one cell thick layer of melanophores occurs within the fibrous tissue. These cells contain numerous membrane-bound, highly electron-dense inclusion bodies (0.3-0.6 micron). They are occasionally seen in Paracheirodon innesi also, whereas they are absent in 2 and 6 days old larvae of M. aeglefinus and prenatal larvae of P. reticulata. Macrophages, capillaries, and nerve bundles occur in the pericardial and subpericardial connective tissue. The present results are discussed and compared with those previously reported for mammalian parietal pericardium.
Topics: Animals; Connective Tissue; Epithelium; Fishes; Microscopy, Electron; Pericardium
PubMed: 6746406
DOI: No ID Found -
Journal of Biomaterials Applications Nov 2013Prosthetic heart valves designed to be implanted percutaneously must be loaded within delivery catheters whose diameter can be as low as 18 F (6 mm). This mandatory... (Comparative Study)
Comparative Study
RATIONALE
Prosthetic heart valves designed to be implanted percutaneously must be loaded within delivery catheters whose diameter can be as low as 18 F (6 mm). This mandatory crimping of the devices may result in deleterious damages to the tissues used for valve manufacturing. As bovine and porcine pericardial tissue are currently given preference because of their excellent availability and traceability, a preliminary comparative study was undertaken to highlight their potential advantages.
MATERIALS AND METHODS
Bovine and pericardium patches were compared morphologically (light microscopy, scanning electron microscopy and transmission electron microscopy). The acute thrombogenicity of both materials was measured in term of platelet uptake and observed by scanning electron microscopy, porcine intact and injured arteries being used as controls. The pericardium specimens were also subjected to uniaxial tensile tests to compare their respective mechanical characteristics.
RESULTS
Both pericardiums showed a layered architecture of collagen bundles presenting some interstitial cells. They displayed wavy crimps typical of an unloaded collagenous tissue. The collagen bundles were not bound together and the fibrils were parallel with characteristic periodicity patterns of cross striations. The mesothelial cells found in vivo on the serous surface were no longer present due to tissue processing, but the adjacent structure was far more compacted when compared to the fibrous side. The fibrinocollagenous surfaces were found to be more thrombogenic for both bovine and porcine tissues and the serous side of the porcine pericardium retained more platelets when compared to the bovine samples, making the acute thrombogenicity more important in the porcine pericardium.
CONCLUSION
Both bovine and porcine pericardium used in cardiovascular implantology can be selected to manufacture percutaneous heart valves. The selection of one pericardium preferably to the other should deserve additional testing regarding the innocuousness of crimping when loaded in delivery catheters and the long-term durability after percutaneous deployment.
Topics: Animals; Cattle; Heart Valve Prosthesis; Microscopy, Electron, Scanning; Microscopy, Electron, Transmission; Pericardium; Swine
PubMed: 23142967
DOI: 10.1177/0885328212465482 -
Bio-medical Materials and Engineering 2017Each year, more than 800,000 vascular and cardiac surgeries are performed therefore, there is a great need for suitable material for bioprosthetic operations. Porcine...
BACKGROUND
Each year, more than 800,000 vascular and cardiac surgeries are performed therefore, there is a great need for suitable material for bioprosthetic operations. Porcine pericardium is a double-walled sac that covers the heart and can be used in vascular and cardiac thoracic surgery.
OBJECTIVE
The aim of the present study was to evaluate the decellularization process and biomechanical properties in porcine pericardial tissue after the decellularization treatment.
METHODS
A detergent based protocol was used for the decellularization of porcine pericardium. Histological analysis and contact cytotoxicity assay were performed. Additionally, biomechanical testing and in vivo biocompatibility by implantation into Wistar Rats were performed.
RESULTS
The histological analysis showed the preservation of the extracellular matrix, without any observable cellular remnants. No toxic effects were noticed when contact cytotoxicity assay performed. The decellularized tissues, after implantation in Wistar Rats, remained for up to 12 weeks without being rejected. Finally, the biomechanical testing showed no significant differences between native and decellularized tissues.
CONCLUSION
In this study, the decellularization of the porcine pericardium produced a non toxic scaffold, free of any cellular remnants, thus serving as an alternative material for tissue engineering applications including heart valve and vascular patch development.
Topics: Animals; Heart Valves; Pericardium; Rats; Rats, Wistar; Swine; Tissue Engineering; Tissue Scaffolds
PubMed: 28854488
DOI: 10.3233/BME-171689 -
Endocrine May 2014Epicardial adipose tissue has recently emerged as new risk factor and active player in metabolic and cardiovascular diseases. Albeit its physiological and pathological... (Review)
Review
Epicardial adipose tissue has recently emerged as new risk factor and active player in metabolic and cardiovascular diseases. Albeit its physiological and pathological roles are not completely understood, a body of evidence indicates that epicardial adipose tissue is a fat depot with peculiar and unique features. Epicardial fat is able to synthesize, produce, and secrete bioactive molecules which are then transported into the adjacent myocardium through vasocrine and/or paracrine pathways. Based on these evidences, epicardial adipose tissue can be considered an endocrine organ. Epicardial fat is also thought to provide direct heating to the myocardium and protect the heart during unfavorable hemodynamic conditions, such as ischemia or hypoxia. Epicardial fat has been suggested to play an independent role in the development and progression of obesity- and diabetes-related cardiac abnormalities. Clinically, the thickness of epicardial fat can be easily and accurately measured. Epicardial fat thickness can serve as marker of visceral adiposity and visceral fat changes during weight loss interventions and treatments with drugs targeting the fat. The potential of modulating the epicardial fat with targeted pharmacological agents can open new avenues in the pharmacotherapy of endocrine and metabolic diseases. This review article will provide Endocrine's reader with a focus on epicardial adipose tissue in endocrinology. Novel, established, but also speculative findings on epicardial fat will be discussed from the unexplored perspective of both clinical and basic Endocrinologist.
Topics: Adipose Tissue; Animals; Endocrine System Diseases; Female; Humans; Male; Metabolic Diseases; Pericardium
PubMed: 24272604
DOI: 10.1007/s12020-013-0099-4 -
Current Cardiology Reports Dec 2023This review presents the etiology, clinical manifestations, diagnostic approach, and treatment of congenital pericardial defects. It also highlights the critical role of... (Review)
Review
PURPOSE OF REVIEW
This review presents the etiology, clinical manifestations, diagnostic approach, and treatment of congenital pericardial defects. It also highlights the critical role of echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance (CMR) in the diagnosis and management approach.
RECENT FINDINGS
Congenital pericardial defects are rare. Although most cases are found incidentally, some cases could potentially be associated with serious outcomes including sudden cardiac death. The diagnosis is often challenging due to non-specific clinical manifestations and electrocardiogram findings. Echocardiography is the first-line imaging investigation for the evaluation of this condition. Advanced cardiac imaging modalities, including CCT and CMR, play important adjuvant roles in establishing the diagnosis and assists with prognostication.
Topics: Humans; Pericardium; Heart Diseases; Magnetic Resonance Imaging; Echocardiography; Cardiac Imaging Techniques
PubMed: 38060098
DOI: 10.1007/s11886-023-02004-3 -
La Radiologia Medica 1990
Review
Topics: Heart Neoplasms; Humans; Magnetic Resonance Imaging; Pericardial Effusion; Pericarditis; Pericardium; Tomography, X-Ray Computed
PubMed: 2217932
DOI: No ID Found -
Journal of Healthcare Engineering 2019Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In...
Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In many cases, impaired HV restoration is not always possible, and the replacement of valves becomes necessary. Bioprosthetic HVs have been used for the replacement of the diseased valves, which is obtained from the sources of bovine and porcine origin, while tissue-engineered heart valves (TEHV) have emerged as a promising future solution. The bioprosthetic valves are prone to become calcified, and thus they last for only ten to fifteen years. The adequate understanding of the correlations between the biomechanics and rheological properties of native HV tissues can enable us to improve the durability of the bioprosthetic HV as well as help in the development of tissue-engineered heart valves (TEHV). In this study, the structural and rheological properties of native bovine aortic HV and pericardium tissues were investigated. The microstructures of the tissues were investigated using scanning electron microscopy, while the rheological properties were studied using oscillatory shear measurement and creep test. The reported results provide significant insights into the correlations between the microstructure and viscoelastic properties of the bovine aortic HV and pericardium tissues.
Topics: Animals; Aortic Valve; Bioprosthesis; Cattle; Elasticity; Heart Valve Prosthesis; Pericardium; Rheology; Swine; Tissue Engineering; Viscosity
PubMed: 31976052
DOI: 10.1155/2019/3290370 -
Journal of Biomedical Materials Research Jun 1993Glutaraldehyde-crosslinked bovine pericardium is widely used in bioprosthetic heart valve fabrication. In an attempt to set a scientific basis for more reproducible...
Glutaraldehyde-crosslinked bovine pericardium is widely used in bioprosthetic heart valve fabrication. In an attempt to set a scientific basis for more reproducible tissue selection, we produced and analyzed topographical maps of glutaraldehyde-treated bovine pericardium. Whole pericardia were divided into specific anatomical areas and their thickness was measured and mapped on templates. In each area, the suture holding power was determined in both parallel and perpendicular (to the base-apex line) directions; analyses of the tearing patterns in each fragment were used to evaluate predominant fiber orientation, and observations were confirmed by polarized light microscopy. Complete maps were superimposed graphically to aid in the selection of certain areas that would have known fiber orientation, high suture holding power, and suitable thickness. Our results describe regional heterogeneity of bovine pericardial structure and mechanical properties, specifically demonstrating variations in thickness, suture holding power, and collagen fiber orientation. Two areas of choice (representing about 35% of the total) were described as suitable for use in bioprosthetic heart valve fabrication.
Topics: Animals; Bioprosthesis; Cattle; Collagen; Glutaral; Heart Valve Prosthesis; Microscopy, Polarization; Pericardium; Sutures; Temperature
PubMed: 8408100
DOI: 10.1002/jbm.820270602