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Elastomeric PGS Scaffolds in Arterial Tissue Engineering
Published on: April 8, 2011
Small Diameter Xenogeneic Extracellular Matrix Scaffolds for Vascular Applications
Manuela Lopera Higuita1, Leigh G Griffiths2
1Mayo Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota.
Insights
Coronary artery bypass graft (CABG) surgery faces challenges with autologous vessels. Xenogeneic extracellular matrix (ECM) scaffolds offer a promising alternative, but overcoming their failure mechanisms is key for successful CABG.
Area of Science:
- Biomaterials Science
- Cardiovascular Surgery
- Tissue Engineering
Background:
- Coronary artery bypass graft (CABG) surgery commonly uses autologous vessels, but harvest complications and limited availability hinder success.
- Acellular extracellular matrix (ECM) scaffolds from xenogeneic sources offer an "off-the-shelf" solution with greater availability for CABG.
Purpose of the Study:
- To review the failure mechanisms of current small-diameter xenogeneic ECM scaffolds for CABG.
- To highlight recent advances in overcoming these failure mechanisms for improved graft patency.
Main Methods:
- Literature review of xenogeneic ECM scaffold research for CABG.
- Analysis of identified failure mechanisms in small-diameter vascular grafts.
- Synthesis of recent advancements in scaffold development.
Main Results:
- Current xenogeneic ECM scaffolds face multiple failure mechanisms that prevent full functionality.
- Significant research efforts are underway to address these limitations.
- Overcoming these challenges is crucial for developing effective ECM-based CABG grafts.
Conclusions:
- Developing functional small-diameter xenogeneic ECM scaffolds for CABG requires overcoming specific failure mechanisms.
- Continued research into biomaterial modifications and tissue engineering strategies is essential.
- Successful development promises to improve CABG outcomes by eliminating autologous graft complications.
Abstract:
Currently, despite the success of percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) remains among the most commonly performed cardiac surgical procedures in the United States. Unfortunately, the use of autologous grafts in CABG presents a major clinical challenge as complications due to autologous vessel harvest and limited vessel availability pose a significant setback in the success rate of CABG surgeries. Acellular extracellular matrix (ECM) scaffolds derived from xenogeneic vascular tissues have the potential to overcome these challenges, as they offer unlimited availability and sufficient length to serve as "off-the-shelf" CABGs. Unfortunately, regardless of numerous efforts to produce a fully functional small diameter xenogeneic ECM scaffold, the combination of factors required to overcome all failure mechanisms in a single graft remains elusive. This article covers the major failure mechanisms of current xenogeneic small diameter vessel ECM scaffolds, and reviews the recent advances in the field to overcome these failure mechanisms and ultimately develop a small diameter ECM xenogeneic scaffold for CABG. Impact Statement Currently, the use of autologous vessel in coronary artery bypass graft (CABG) is common practice. However, the use of autologous tissue poses significant complications due to tissue harvest and limited availability. Developing an alternative vessel for use in CABG can potentially increase the success rate of CABG surgery by eliminating complications related to the use of autologous vessel. However, this development has been hindered by an array of failure mechanisms that currently have not been overcome. This article describes the currently identified failure mechanisms of small diameter vascular xenogeneic extracellular matrix scaffolds and reviews current research targeted to overcoming these failure mechanisms toward ensuring long-term graft patency.
