Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1705100
Original Basic Science
Georg Thieme Verlag KG Stuttgart · New York

Sterilization and Cross-Linking Combined with Ultraviolet Irradiation and Low-Energy Electron Irradiation Procedure: New Perspectives for Bovine Pericardial Implants in Cardiac Surgery

Simona Walker*
1  Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
,
Claudia Dittfeld*
2  Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
,
Aline Jakob
2  Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
,
Jessy Schönfelder
1  Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
,
Ulla König
1  Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, Dresden, Germany
,
Sems-Malte Tugtekin
2  Department of Cardiac Surgery, Faculty of Medicine Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
› Author Affiliations
Further Information

Publication History

22 August 2019

07 January 2020

Publication Date:
01 March 2020 (online)

Abstract

Background Bovine pericardium is the major natural source of patches and aortic valve substitutes in cardiac repair procedures. However, long-term tissue durability and biocompatibility issues lead to degeneration (e.g., calcification) that requires reoperation. Tissue preparation strategies, including glutaraldehyde fixation, are reasons for the deterioration of pericardial tissues. We describe a pretreatment procedure involving sterilization and cross-linking combined with ultraviolet (UV) irradiation and low-energy electron irradiation (SULEEI). This innovative, glutaraldehyde-free protocol improves the mechanical aspects and biocompatibility of porcine pericardium patches.

Methods We adopted the SULEEI protocol, which combines decellularization, sterilization, and cross-linking, along with UV irradiation and low-energy electron irradiation, to pretreat bovine pericardium. Biomechanics, such as ultimate tensile strength and elasticity, were investigated by comparing SULEEI-treated tissue with glutaraldehyde-fixed analogues, clinical patch materials, and an aortic valve substitute. Histomorphological and cellular aspects were investigated by histology, DNA content analysis, and degradability.

Results Mechanical parameters, including ultimate tensile strength, elasticity (Young's modulus), and suture retention strength, were similar for SULEEI-treated and clinically applied bovine pericardium. The SULEEI-treated tissues showed well-preserved histoarchitecture that resembled all pericardial tissues investigated. Fiber density did not differ significantly. DNA content after the SULEEI procedure was reduced to less than 10% of the original tissue material, and more than 50% of the SULEEI-treated pericardium was digested by collagenase.

Conclusion The SULEEI procedure represents a new treatment protocol for the preparation of patches and aortic valve prostheses from bovine pericardial tissue. The avoidance of glutaraldehyde fixation may lessen the tissue degeneration processes in cardiac repair patches and valve prostheses.

* Simona Walker and Claudia Dittfeld contributed equally but to different parts of data and manuscript preparation steps.


Supplementary Material