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Objectives: Cell sources for cardiovascular tissue engineering (TE) are scant. However, the need for an ideal TE cardiovascular implant persists. We investigated the cardiotomy reservoir (CR) as a potential cell source that is more accessible and less ethically problematic. Methods: CR (n = 10) were removed from the bypass system after surgery. Isolation was performed using different isolation methods: blood samples were taken from the cardiopulmonary bypass and centrifuged at low density. The venous filter screen was cut out and placed into petri dishes for cultivation. The spongelike filter was removed, washed and treated in the same way as the blood samples. After cultivation, cell lines of fibroblasts (FB) and endothelial cells (EC) were obtained for analysis. The cells were seeded on polyurethane patches and analyzed via scanning electron microscopy (SEM), Life/Dead assay and immunohistochemistry. Results: No correlation between age, time of surgery and quality of cells was observed. The successful extraction of FB and was proven by positive staining results for TE-7, CD31 and vWF. Cell morphology, cytoskeleton staining and quantification of proliferation using WST-1 assay resembled the cells of the control group in all ways. The topography of a confluent and vital cell layer after cell seeding was displayed by SEM analysis, Life/Dead Assay and immunohistochemistry. The establishment of an extracellular matrix (ECM) was proven by positive staining for collagen IV, laminin, fibronectin and elastin. Conclusions: Viable FB and EC cell lines were extracted from the CR after surgery. Easy access and high availability make this cell source destined for widespread application in cardiovascular tissue engineering.

Anticoagulation is used to prevent thromboembolism; inferior vena cava filters are an alternative in patients with contraindications to anticoagulation. Although it is safe and effective, there are recognized complications related to inferior vena cava filter placement. We describe the case of a young man with congenital solitary left pelvic kidney who required unique filter placement to suit the anatomy and surgical removal after entrapment of the filter-snare complex in the left internal iliac vein. Patients may also acquire solitary pelvic kidneys after renal transplantation. This anatomy poses unique challenges to venous filter placement and requires tailored management. Keywords: Venous interruption filter, Abnormal anatomy, Filter entrapment, Surgical removal

Objetivo: La invasión vascular en forma de trombo tumoral sucede en un no desdeñable porcentaje de las neoplasias renales, la importancia de la extensión cefálica del trombo en el pronóstico es discutida actualmente pero en ausencia de metástasis a distancia, el tratamiento quirúrgico es mandatorio. Método: Presentamos el caso de un paciente de 56 años al que intervenimos en nuestro centro, portador de filtro en vena cava inferior mediante abordaje toraco-abdominal con circulación extracorpórea (CEC), hipotermia profunda (por debajo de los I8ºC) y retroperfusión cerebral. Resultados: Si bien tiempo atrás se pensaba que la presencia de trombo tumoral ensombrecía el pronóstico de estos pacientes, actualmente sabemos que con tratamiento quirúrgico, en casos seleccionados, se obtienen buenos resultados en términos de supervivencia y tiempo libre de enfermedad. Conclusión: Pensamos que el implante de filtros venosos, puede incrementar la complejidad de la cirugía. Objective: Vascular invasion in the form of tumour thrombus appears in a significant percentage of renal neoplasias. The importance of cephalic extension of the thrombus in prognosis is currently under discussion, but surgical treatment is mandatory in the absence of distant metastasis. Methods: We report the case of a 56-year-old male patient with a filter in the inferior vena cava, who underwent surgery in our department through a thoracoabdominal approach with extracorporeal circulation, deep hypothermia (below 18ºC) and cerebral retrograde perfusion. Results: Although in the past it was believed tumour thrombus worsened prognosis in these patients, currently we know that surgical treatment, in selected cases, gives good results in terms of survival and disease-free time. Conclusions: We think the implementation of venous filters may increase the complexity of surgery.

Purpose: To report the percutaneous endovascular repair of massive congenital arteriovenous malformations (AVMs) of the right arm complicated by tissue ischemia, severe edema, and life-threatening recurrent hemorrhagic episodes. Methods and Results: A 25-year-old man with a 3-year history of symptomatic upper right arm AVMs had been treated unsuccessfully with surgical ligation and coil embolization. The arm had become massively enlarged, disfigured, severely painful, and unusable, with extension of swelling to the upper chest. Under compassionate use as part of an investigational protocol, the AVMs were closed with 6 overlapping Wallgraft endoluminal prostheses deployed in the right brachial, axillary, and subclavian arteries, preserving the vertebral and distal circulations. Unfortunately, the patient suffered numerous pulmonary emboli and died 2 days after the procedure. Conclusions: Percutaneous treatment of massive AVMs appears feasible with the Wallgraft endoprosthesis, but optimal postprocedural management of such large anomalies should include immediate venous filter placement and aggressive anticoagulation therapy with intravenous heparin.

To evaluate in vitro the functional efficacy of a new variable-sized, temporary venous filter, the Spring filter (SF). The SF was tested in a flow phantom, using flexible, thin-walled polyethylene tubes 12, 14, and 16 mm in diameter to simulate veins. Clots of three sizes were used: 6 × 10 mm, 6 × 20 mm, 9 × 20 mm. Filter deployment was performed, ensuring that its functional diameter after placement was a predetermined multiple of the radius ‘r’ of the tube: 3.0r, 2.8r, 2.6r, 2.4r. The terminal coil was visually examined for changes in configuration. Clot retention by the filter for a period of 3 min was recorded as a success. The baseline intraluminal pressure and the maximum pressure reached after clot introduction were recorded. The trapping ability was calculated from the results for 10 clots. The effect of the following parameters on filter function were studied: size of embolus, caliber of simulated vein, and functional diameter of filter. The filter configuration was stable. Not a single instance of axial tilting occurred on deployment. Functional diameter was the major determinant of filter function. One hundred percent of clots were trapped irrespective of clot size and tube caliber when the functional diameter was 3.0r. Only 73% (95% confidence interval (CI): 57%–88%) and 77% (95% CI: 61%–92%) of small emboli were held up by the filter when the functional diameters were 2.6r and 2.4r, respectively (p = 0.0001). A significant reduction in clot trapping was encountered even with medium clots when the functional diameter was 2.4r (p = 0.02). Against the background of available data on retrievable vena caval filters, the current model of SF warrants further investigation.