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Zhuravleva IY, Shadanov AA, Surovtseva MA, Vaver AA, Samoylova LM, Vladimirov SV, Timchenko TP, Kim II, Poveshchenko OV. Which Gelatin and Antibiotic Should Be Chosen to Seal a Woven Vascular Graft? Int J Mol Sci 2024; 25:965. [PMID: 38256039 PMCID: PMC10816219 DOI: 10.3390/ijms25020965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Among the vascular prostheses used for aortic replacement, 95% are woven or knitted grafts from polyester fibers. Such grafts require sealing, for which gelatin (Gel) is most often used. Sometimes antibiotics are added to the sealant. We used gelatin type A (GelA) or type B (GelB), containing one of the three antibiotics (Rifampicin, Ceftriaxone, or Vancomycin) in the sealant films. Our goal was to study the effect of these combinations on the mechanical and antibacterial properties and the cytocompatibility of the grafts. The mechanical characteristics were evaluated using water permeability and kinking radius. Antibacterial properties were studied using the disk diffusion method. Cytocompatibility with EA.hy926 endothelial cells was assessed via indirect cytotoxicity, cell adhesion, and viability upon direct contact with the samples (3, 7, and 14 days). Scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS) were used to visualize the cells in the deep layers of the graft wall. "GelA + Vancomycin" and "GelB + vancomycin" grafts showed similar good mechanical characteristics (permeability~10 mL/min/cm2, kinking radius 21 mm) and antibacterial properties (inhibition zones for Staphilococcus aureus~15 mm, for Enterococcus faecalis~12 mm). The other samples did not exhibit any antibacterial properties. The cytocompatibility was good in all the tested groups, but endothelial cells exhibited the ability to self-organize capillary-like structures only when interacting with the "GelB + antibiotics" coatings. Based on the results obtained, we consider "GelB + vancomycin" sealant to be the most promising.
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Affiliation(s)
- Irina Yu. Zhuravleva
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Aldar A. Shadanov
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Maria A. Surovtseva
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
- Research Institute of Clinical and Experimental Lymphology, Branch of the Federal Research Center «Institute of Cytology and Genetics SB RAS», 2 Timakova St., Novosibirsk 630060, Russia
| | - Andrey A. Vaver
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Larisa M. Samoylova
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Sergey V. Vladimirov
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Tatiana P. Timchenko
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
| | - Irina I. Kim
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
- Research Institute of Clinical and Experimental Lymphology, Branch of the Federal Research Center «Institute of Cytology and Genetics SB RAS», 2 Timakova St., Novosibirsk 630060, Russia
| | - Olga V. Poveshchenko
- E. Meshalkin National Medical Research Center of the RF Ministry of Health, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.S.); (M.A.S.); (A.A.V.); (L.M.S.); (S.V.V.); (T.P.T.); (I.I.K.); (O.V.P.)
- Research Institute of Clinical and Experimental Lymphology, Branch of the Federal Research Center «Institute of Cytology and Genetics SB RAS», 2 Timakova St., Novosibirsk 630060, Russia
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Sazzad F, Ramanathan K, Moideen IS, Gohary AE, Stevens JC, Kofidis T. A Systematic Review of Individualized Heart Surgery with a Personalized Prosthesis. J Pers Med 2023; 13:1483. [PMID: 37888094 PMCID: PMC10608049 DOI: 10.3390/jpm13101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Personalized surgery is not just a new trend but rather a patient-specific approach to therapy that makes it possible to adopt a targeted approach for a specific patient and closely mirrors the approach of personalized medicine. However, the application of tailored surgery in the context of cardiovascular replacement surgery has not been systematically reviewed. The ability to customize a device is highly dependent on the collection of radiological image data for precise prosthesis modeling. These facts are essential to "tailor-made" device design for precise prosthesis implantation. According to this study, computed tomography (CT) was the most prominent imaging modality; however, transesophageal echocardiography and echocardiography were also found to be helpful. Additionally, a dynamic finite element simulation was also found to be an attractive alternative to the finite element analysis for an in-silico experiment. Nonetheless, there is a paucity of relevant publications and only sporadic evidence. More clinical studies have been warranted, notwithstanding that the derived data and results from this insight into the use of therapeutic interventions may be evidence of multiple directives in clinical practices and beyond. This study may help the integration of personalized devices for better comprehension of predicted clinical outcomes, thus leading towards enhanced performance gains.
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Affiliation(s)
- Faizus Sazzad
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Kollengode Ramanathan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore 119228, Singapore
| | - Irwan Shah Moideen
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Abdulrahman El Gohary
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - John Carey Stevens
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
| | - Theo Kofidis
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
- Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore 119228, Singapore
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Tamura K, Tatsuishi W, Konishi Y, Konno N, Kato Y, Abe T. Hemolytic anemia caused by kinked graft 6 months after aortic dissection repair. J Cardiothorac Surg 2022; 17:308. [DOI: 10.1186/s13019-022-02079-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Clinically insignificant hemolytic anemia is occasionally a complication of prosthetic valve replacement. However, hemolysis related to kinked grafts is a very rare complication after central repair for acute aortic dissection.
Case presentation
A 42-year-old man had undergone replacement of the ascending aorta and a root repair for type A aortic dissection 6 months previously. Laboratory data showed mild hemolysis 5 months later, and he began to complain of fatigue on exertion. The serum hemoglobin level reduced to 8.6 g/dL, and lactate dehydrogenase levels increased to 3071 IU/L with gross change in urine color, indicating hemoglobinuria. We diagnosed mechanical hemolytic anemia caused by a kinked graft and planned a repeat operation. The kinked graft was resected and graft-graft anastomosis was performed. Postoperatively, the clinical course was uneventful, and the hemolytic anemia completely resolved.
Conclusion
We herein report a case of hemolytic anemia caused by kinking of the graft 6 months after acute aortic dissection repair. The diagnosis was swiftly made, and the patient was successfully managed with redo surgery.
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