Tissue-Engineered Constructions for the Needs of Cardiovascular Surgery: Possibilities of Personalization and Prospects for Use (Problem Article)

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Abstract

In the market for products for the needs of cardiovascular surgery, there is still no effective vascular prosthesis with a diameter of less than 4 mm, despite the continuous increase in the incidence of atherosclerosis and the increase in the number of surgical operations to restore blood flow in the affected arteries. At the same time, vascular tissue engineering has diverse methodological approaches for the development of effective functionally active small-diameter vascular prostheses suitable for adaptive growth and regeneration in situ. An important aspect is the possibility of personalizing the created prostheses not only by taking into account the individual anatomy of the patient’s vascular bed, but also by using autologous components to create such a prosthesis, which can be obtained directly from the recipient. The presented problematic article reflects the main results on the creation of biodegradable vascular prostheses of small diameter, obtained at the Research Institute of the Research institute for complex issues of cardiovascular diseases (Kemerovo). The functionality of the prostheses was provided both through the incorporation of biologically active components with proangiogenic potential for the purpose of complete remodeling in situ, and the formation of cell-populated vascular prostheses using autologous cells and proteins from patients with coronary heart disease. In the future, these vascular prostheses can cover the clinical need for elective and emergency cardiovascular surgery, neuro- and microsurgery, and military field vascular surgery.

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About the authors

Larisa V. Antonova

Research Institute for Complex Issues of Cardiovascular Diseases

Author for correspondence.
Email: antonova.la@mail.ru
ORCID iD: 0000-0002-8874-0788
SPIN-code: 8634-3286

MD, PhD
Russian Federation, Kemerovo

Olga L. Barbarash

Research Institute for Complex Issues of Cardiovascular Diseases

Email: barbol@kemcardio.ru
ORCID iD: 0000-0002-4642-3610
SPIN-code: 5373-7620

MD, PhD, Professor, Academician of the RAS

Russian Federation, Kemerovo

Leonid S. Barbarash

Research Institute for Complex Issues of Cardiovascular Diseases

Email: reception@kemcardio.ru
ORCID iD: 0000-0001-6981-9661

MD, PhD, Professor, Academican of the RAS

Russian Federation, Kemerovo

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Supplementary files

Supplementary Files
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2. Figure 1. Proposed scheme of the mechanisms that determine the cellular response and recruitment of cells into the wall of a biodegradable vascular prosthesis PHBV/PCL/GF mix

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3. Figure 2. Comparative evaluation of patency and remodeling of vascular prostheses PHBV/PCL/GF mix with a diameter of 1.5 mm after 12 months of implantation in the abdominal part of the rat aorta (in comparison with unmodified analogues) [12]

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4. Figure 3. Biodegradable vascular prosthesis PHBV/PCL/GF mixHep/Ilo with anti-aneurysmal scaffold

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5. Figure 4. Comparative histological picture of the wall of the remodeled vascular prosthesis PHBV/PCL/GF mixHep/Ilo with a diameter of 4 mm 12 months after implantation and the intact sheep carotid artery [30]

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6. Figure 5. Relative number of positive culture results at blood sampling points in patients undergoing coronary bypass surgery (CABG) and percutaneous coronary intervention (PCI), %

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7. Figure 6. Examples of histograms of various antigens on CD45– and HUVEC (flow cytometry) populations [31]

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8. Figure 7. Photographs of CD45– and HUVEC colonies taken with a confocal microscope [31]

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9. Figure 8. Biological properties of PHBV/PCL matrices coated with various extracellular matrix proteins

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10. Figure 9. Retention of cells on the surface of biodegradable vascular prostheses PHBV/PCL coated with various extracellular matrix proteins under static and pulsating flow conditions

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