A new vascular coupling device: assessment of MRI issues at 3-tesla.

OBJECTIVE: Vascular grafting frequently involves a time-consuming operation. A new vascular coupling device (VCD) made from metallic material was recently developed that may be advantageous because of the reduced operative time and decreased patient risks. Because of the metal, there are safety concerns related to MRI. Therefore, the purpose of this investigation was to use standardized testing techniques to evaluate MRI issues for this VCD in association with a 3-Tesla MR system. METHODS: The VCD (corlife oHG, Hannover, Germany) was evaluated for magnetic field interactions (translational attraction and torque), MRI-related heating, and artifacts at 3-Tesla. MRI-related heating was assessed with the VCD in a gelled-saline-filled phantom with MRI performed at a whole body averaged SAR of 2.9-W/kg for 15-min. Artifacts were assessed using T1-weighted, spin echo, and gradient echo pulse sequences. RESULTS: The VCD exhibited minor magnetic field interactions and minimal heating (maximum temperature elevation, 1.8°C). Artifacts were relatively small in relation to the size and shape of this implant. The lumen of the VCD could not be visualized using the gradient echo pulse sequence. CONCLUSIONS: The metallic VCD that underwent evaluation is MR conditional for a patient undergoing an MRI procedure at 3-Tesla or less.

Functional neointima characterization of vascular prostheses in human.

BACKGROUND: The purpose of this study was to evaluate neointimal functionality of synthetic vascular grafts repopulated by host cells after implantation. METHODS: We obtained reseeded inflow and outflow cannulas of 2 patients undergoing orthotopic heart transplantation after left ventricular assist device implantation 9 and 10 months before. After cell isolation we examined cellular function of reseeded cells and their capability to form a functional endothelial layer applying immunohistologic markers and quantitative Western blot for endothelial nitric oxide synthase activity. RESULTS: Neointima formation in inflow and outflow cannulas differs macroscopically and by histologic appearance. The neointima formation on the surface of the polyethylene terephthalate fiber (Dacron) grafts differs substantially from native aortic vessel wall with respect to cellular and extracellular matrix composition and cellular function. CONCLUSIONS: The neointima of Dacron prostheses is composed of cells with rudimentary physiologic endothelial function. We conclude that synthetic matrices are not suitable scaffolds for generating functional cardiovascular implants.

In vivo model for cross-species porcine endogenous retrovirus transmission using tissue engineered pulmonary arteries.

OBJECTIVE: Acellularised porcine scaffolds have been successfully used for cardiovascular tissue engineering. However, there is concern about the possibility of porcine endogenous retrovirus (PERV) transmission. In this study we developed an in vivo model for cross-species PERV transmission. METHODS: In vitro autologous repopulated porcine pulmonary arteries (n=6) were implanted in sheep in orthotopic position. Blood samples were collected regularly up to 6 months after implantation and tested for PERV by means of polymerase chain reaction and reverse transcriptase-polymerase chain reaction. Explanted tissue engineered pulmonary arteries were tested for PERV sequences. RESULTS: PERV DNA was detectable in acellularised porcine scaffolds. No PERV sequences were detectable 6 months after implantation of in vitro repopulated acellularised porcine pulmonary arteries and in all tested peripheral blood samples. CONCLUSIONS: Acellularised porcine matrix scaffolds can be used for cardiovascular tissue engineering of autologous grafts without risk of PERV transmission.