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In vitro comparison of three percutaneous atrial septal defect closure devices for endothelialisation and
Yael Levy1, Zakaria Jalal2, Audrey Aussel3
1Department of Paediatric and Adult Congenital Cardiology, Bordeaux University Hospital (CHU), 33600 Pessac, France.
Insights
This study found that three atrial septal defect (ASD) closure devices showed similar endothelial cell adhesion and proliferation in vitro. Further research is needed to confirm these findings, considering shear stress and antithrombotic treatments.
Area of Science:
- Cardiovascular research
- Biomaterials science
- Medical device engineering
Background:
- Percutaneous closure is standard for atrial septal defects (ASD).
- Delayed complications can arise from incomplete device endothelialization.
Purpose of the Study:
- Compare endothelialization and hemocompatibility of three ASD closure devices: Nit-Occlud® ASD-R, Hyperion™ ASDO, and Amplatzer™ Septal Occluder.
- Evaluate human endothelial progenitor cell (EPC) adhesion and proliferation on device surfaces.
- Assess the hemocompatibility of the devices.
Main Methods:
- Isolated and cultured human EPCs from umbilical cord blood.
- Seeded device samples with EPCs (100,000 cells/cm²).
- Assessed EPC adhesion at 3 and 24 hours, and proliferation over 12 days.
- Evaluated hemocompatibility using complement C3a, platelet, and coagulation activation assays.
Main Results:
- No significant differences in EPC adhesion or proliferation were observed among the three devices.
- All devices demonstrated time-dependent EPC proliferation, with significant growth noted by day 8 or 10.
- No complement or platelet activation occurred within 15 minutes of device contact.
- Minimal coagulation activation was observed for all three devices.
Conclusions:
- Despite varying designs and coatings, the three ASD occluders exhibited similar in vitro endothelial cell adhesion and proliferation.
- Further studies incorporating shear stress and antithrombotic treatments are recommended to validate these findings.
Background:
Percutaneous device closure of atrial septal defect (ASD) is the gold-standard treatment, but several delayed complications may occur as a result of incomplete device endothelialisation.
Aims:
In this in vitro study, we compared three ASD closure devices [Nit-Occlud® ASD-R (device 1); Hyperion™ ASDO (device 2); and Amplatzer™ Septal Occluder (device 3)] in terms of the endothelialisation process, using human endothelial progenitors cells (EPCs), and haemocompatibility.
Methods:
EPCs from umbilical cord blood were extracted, cultured and characterised. Device samples were seeded with 100,000 cells/cm2. EPC adhesion was investigated at 3 and 24hours, and EPC proliferation was monitored, which allowed longitudinal follow-up (days 1-12). Haemocompatibility of device samples was assessed using a complement C3a assay and platelet and coagulation activation.
Results:
With regard to EPC adhesion and proliferation, no statistically significant differences were found between the three devices. We observed for each device a significant time-dependent EPC proliferation, appearing at day 8 for devices 2 and 3 and day 10 for device 1. No complement or platelet activation occurred within 15minutes of contact with devices. However, there was minimal activation of coagulation for the three devices.
Conclusions:
In this in vitro study we showed that, despite the three ASD occluders having different device designs and coatings, adhesion and proliferation of human endothelial cells was similar for all devices. This should be further confirmed by similar studies including shear stress forces and anti-thrombotic treatments.
