Search

Background: The aim of our study was to develop a completely scaffold-free, viable, contractile cardiac tissue capable of being grafted into the damaged native heart., Methods: Our technology is based on the fundamental characteristics of the self-assembling nature of cells. We created contractile cardiac spheroids by plating a mixture of rat neonatal ventricular cardiomyocytes, human dermal fibroblasts, and human coronary microartery endothelial cells in ultralow attachment plates. First, the optimal cell ratios for the 3 cell sources were determined. Next, approximately 1 × 10(4) optimal spheroids were fused into a patch-like construct, and the morphologic characteristics and mechanical functions of these patches were evaluated. Finally, the cardiac patches were grafted into the hearts of F344 nude rats, and histologic studies were performed after transplantation., Results: Synchronous beating of the cardiac patch was confirmed electrophysiologically and mechanically. A micronetwork of endothelial cells was also demonstrated in the construct, and the histologic study performed 5 days after transplantation showed the grafts to be viable, with functioning microvascular structures inside the graft tissue., Conclusions: We consider the application of our scaffold-free 3-dimensional tissue engineering technology to cardiac regeneration therapy is feasible and expect that this technology will become a promising tool for the treatment of end-stage heart failure., (Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to develop a method for real-time, fiberoptic, intracardiac imaging to serve as a platform for closed-chest, intracardiac surgery on the beating heart., Description: Fiberoptic cardioscopy of the left and right heart was conducted in a porcine model. A cardiopulmonary bypass circuit maintained systemic organ perfusion and a separate circuit replaced intracardiac blood with oxygenated, modified Krebs-Henseleit perfusate., Evaluation: Video images of structures in the left and right sides of an in vivo beating heart were obtained, including the inner surface of the left and right atria and ventricles, the mitral and aortic valves, the Thebesian veins, and the coronary sinus. Effective isolation of the heart from systemic and intracardiac blood flow and control of perfusion rates were important factors for successful image acquisition., Conclusions: Fiberoptic cardioscopy is a novel approach that allows for visualization of the structures within a nonarrested heart on bypass. It lays the groundwork for a platform that could lead to more successful percutaneous valvular and intracardiac procedures in a stable hemodynamic environment.

Purpose: This study evaluated the short-term feasibility of a novel epicardial device that treats functional mitral regurgitation by simultaneously changing the mitral and the left ventricular geometry. Description: We implanted a prototype device that consists of 2 tissue anchors, a deflector, and a flexible tightening chord in 7 mongrel dogs with heart failure and functional mitral regurgitation induced by rapid ventricular pacing. Hemodynamic and echocardiographic data were obtained before and after device implantation. Evaluation: The device acutely reduced the mitral regurgitation grade from 3.2 ± 0.3 to 0.9 ± 0.5 (p < 0.001). Left ventricular end-diastolic volume (79.6 ± 23.6 to 61.2 ± 16.9 mL; p = 0.004) and end-systolic volume (63.1 ± 17.3 to 49.2 ± 12.3 mL; p = 0.006) decreased substantially. End-systolic elastance significantly increased from 1.9 ± 1.0 to 2.6 ± 1.4 mm Hg/mL (p = 0.02). Device implantation did not alter coronary perfusion. Conclusions: The epicardial device acutely reduced functional mitral regurgitation and improved left ventricular geometry. Further studies are required to demonstrate the long-term safety and efficacy of this concept. [Copyright &y& Elsevier]