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Published on: November 24, 2014
One-year patency of a novel biorestorative polymeric coronary artery bypass conduit
Isaac George1, Paulo Neves2, Martijn Cox2
1Division of Cardiothoracic Surgery/Structural Heart & Valve Center, New-York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
Insights
A new biorestorative vascular conduit, XABG, shows promise for coronary artery bypass graft (CABG) surgery. This novel graft remained patent for 12 months in a patient, addressing the need for better graft options.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Engineering
- Vascular Grafts
Background:
- Coronary artery bypass graft (CABG) surgery is standard for complex coronary artery disease.
- Saphenous vein grafts (SVG) have high failure rates (30% at 1 year, 50% at 10 years).
- A need exists for durable, off-the-shelf vascular conduits for CABG.
Purpose of the Study:
- To assess the safety and feasibility of the XABG conduit in a routine CABG procedure.
- To evaluate the patency of a novel biorestorative polymeric conduit.
Main Methods:
- A 70-year-old male patient with three-vessel disease underwent CABG using the XABG conduit.
- The XABG conduit was implanted in a non-left anterior descending artery position.
- Graft patency was assessed using TIMI flow and cardiac computed tomography.
Main Results:
- The XABG conduit demonstrated TIMI 3 flow at 6 months post-implantation.
- Graft patency was confirmed by cardiac computed tomography at 12 months.
- The procedure was completed safely in a routine CABG operation.
Conclusions:
- The XABG conduit appears safe and feasible for CABG surgery.
- This novel conduit shows potential for improved long-term patency compared to traditional grafts.
- XABG represents a promising solution for the unmet clinical need in CABG procedures.
Abstract:
Coronary artery bypass graft (CABG) surgery remains the gold standard in the treatment of complex coronary artery disease. Saphenous vein grafts (SVG) are commonly used for the non-left anterior descending artery. However, SVG failure rates in CABG surgery have been reported to be as high as 30% at 1 year and ∼50% at 10 years. Despite suboptimal performance, ∼80% of all CABG surgery includes SVG graft use. Therefore, an off-the-shelf, small-diameter vascular conduit with good patency rates remains a large unmet clinical need. XABG (Xeltis BV, Eindhoven, The Netherlands), a novel supramolecular electrospun biorestorative polymeric conduit with an embedded nitinol microskeleton, is under clinical development to fulfill this unmet need. This case report aims to demonstrate the safety and feasibility of this conduit in a routine CABG operation with implantation in a 70-year-old male patient with three-vessel disease. The XABG conduit remained patent with TIMI 3 flow at 6 months, and patency was confirmed by cardiac computed tomography at 12 months.
