Long-term results of a new antithrombogenic cardiac wall substitute

We evaluated the long-term results of a new antithrombogenic cardiac wall substitute which is composed of collagen-coated ultrafine polyester mesh cross-linked by a hydrophilic polyepoxy compound (CUFP), and compared it with glutaraldehyde-treated equine pericardium (GA graft). In an animal study, 20 CUFPs and 18 GA control grafts were implanted as patches in the right ventricular outflow tract in 38 dogs. In the CUFP at 28 days after implantation, a thin neointima, which was almost endothelialized, had been formed. Fibroblasts and vasa vasorum were seen inside both the neointima and the graft wall. At 168 days, transmission electron microscopy revealed smooth muscle-like cells in the neointima, with endothelialization. The CUFP at 486 days had maintained a white, shiny, smooth, thin, and uniform neointima with endothelialization. Neither ulcer nor thrombus formation was seen on the surface, while in the GA graft at 353 days, no endothelialization was noticed in the center and almost no fibroblasts had infiltrated into the graft wall. From these results, the CUFP should be an ideal candidate for cardiac wall substitution.