A new biological membrane for pericardial closure

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Surgical Innovation

Background:

• Pericardial defects require effective substitutes to restore cardiac function.
• Polytetrafluoroethylene (PTFE) membranes have limitations as pericardial substitutes, including significant adhesion formation.
• Human amniotic membrane (AM) presents a potential biological alternative due to its inherent properties.

Purpose of the Study:

• To evaluate glutaraldehyde-treated human amniotic membrane (AM) as a biological pericardial substitute.
• To compare the performance of AM against polytetrafluoroethylene (PTFE) membrane in a canine pericardial defect model.
• To assess adhesion formation, host-to-graft reaction, and tissue integration of both materials.

Main Methods:

• A comparative study involving four dogs undergoing right thoracotomy.
• Excision of pericardial portions and replacement with glutaraldehyde-treated AM and PTFE patches.
• Evaluation of materials after 18 weeks, including macroscopic assessment and histopathological examination.

Main Results:

• AM patches exhibited minimal extrapericardial and no epicardial adhesions, contrasting with moderate to severe adhesions for PTFE.
• Histopathology revealed preserved AM integrity with minimal neovascularization and lymphocytic infiltration, while PTFE showed severe inflammatory infiltration and fibroblast proliferation.
• AM demonstrated low immunogenicity, eliciting a minimal host-to-graft reaction.

Conclusions:

• Glutaraldehyde-treated human amniotic membrane (AM) is a promising pericardial substitute, demonstrating superior performance to PTFE.
• AM's low immunogenicity contributes to reduced adhesion formation.
• Challenges with AM graft suturing strength require further investigation and potential improvements.