Thorac Cardiovasc Surg 2010; 58 - MP25
DOI: 10.1055/s-0029-1246682

Fibrin-based tissue engineered vascular graft in carotid artery position – the first in vivo experiences

S Koch 1, B Tschoeke 1, T Deichmann 2, V Ella 3, N Gronloh 4, T Gries 2, R Tolba 4, M Kellomäki 3, T Schmitz-Rode 1, S Jockenhoevel 1
  • 1Helmholtz Institute, RWTH Aachen University, Applied Medical Engineerig, Aachen, Germany
  • 2Institut für Textiltechnik der RWTH Aachen, Aachen, Germany
  • 3Tampere University of Technology, Institute of Biomaterials, Tampere, Finland
  • 4University Hospital Aachen, Institute for Laboratory Animal Research, Aachen, Germany

Objective: The fate of bypass procedures is related to the quality of bypass material. The gold-standard are the autologous grafts, but in 7% the available grafts are of poor quality. Tissue-engineering promising an alternative with regard to the low patency rate of synthetic bypass materials. Nevertheless the crux in tissue-engineering of vascular grafts is the long production time. For this reason, we developed a vascular composite graft with an integrated macroporous mesh and a viable endothelial cell layer to guarantee sufficient mechanical properties and an excellent hemocompatibility.

Material & methods: A molding technique was developed to integrate a macroporous, biodegradable PLA-mesh (pore size ˜ 1–2mm) in the wall of the graft (I.D. 5mm). The vascular wall bases on fibrin gel and autologous cells of carotid origin. After 21 weeks in vitro conditioning the grafts were implanted in the carotid artery position of sheep (n=6) for up to 6 month. As control a GoreTex graft was used on the contralateral side.

Results: Tissue development in fibrin gel matrix was excellent with viable myofibroblasts surrounded by well-structured collagen bundles. All tissue-engineered grafts could be implanted with out problems. Furthermore we could demonstrate the patency of the novel tissue-engineerd graft up-to 6 month.

Summary: Rapid production of tissue-engineered, small diameter vascular grafts with adequate mechanical properties within a short time period and with sufficient patency rate seems feasible. On goging long-time studies has to demonstrate the benefit of such a new technique for clinical use.