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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Preservation of conductive propagation after surgical repair of cardiac defects with a bio-engineered conductive patch

  • Sheng He
    Affiliations
    Department of Radiology, The First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China

    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
    Search for articles by this author
  • Huifang Song
    Affiliations
    Department of Radiology, The First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China

    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
    Search for articles by this author
  • Jun Wu
    Affiliations
    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
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  • Shu-Hong Li
    Affiliations
    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
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  • Richard D. Weisel
    Affiliations
    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
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  • Hsing-Wen Sung
    Affiliations
    Department of Chemical Engineering, National Tsing Hua University, Hsinchu, Taiwan
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  • Author Footnotes
    1 These authors have contributed equally to this work.
    Jianding Li
    Correspondence
    Reprint requests: Jianding Li, MD, Shanxi Medical University, No.85 Jie Fang Nan Lu, Taiyuan, Shanxi, China 030001.
    Footnotes
    1 These authors have contributed equally to this work.
    Affiliations
    Department of Radiology, The First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work.
    Ren-Ke Li
    Correspondence
    Reprint requests: Ren-Ke Li, MD, PhD, Toronto Medical Discovery Tower, Room 3-702, 101 College Street, Toronto, ONM5G1L7, Canada. Telephone: 416-581-7492. Fax:416-581-7493.
    Footnotes
    1 These authors have contributed equally to this work.
    Affiliations
    Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Toronto General Research Institute, Division of Cardiovascular Surgery, University Health Network, Toronto, Ontario, Canada
    Search for articles by this author
  • Author Footnotes
    1 These authors have contributed equally to this work.
Published:December 20, 2017DOI:https://doi.org/10.1016/j.healun.2017.12.011

      Background

      Both stable and biodegradable biomaterials have been used to surgically repair congenital cardiac defects. However, neither type of biomaterial can conduct electrical activity. We evaluated the conductivity and efficacy of a newly synthesized conductive polypyrrole–chitosan (Ppy+Chi) gelfoam patch to support cardiomyocyte (CM) viability and function in vitro and to surgically repair a cardiac defect in vivo.

      Methods

      Ppy+Chi was incorporated into gelfoam (Gel) to form a 3-dimensional conductive patch. In vitro, patch characteristics were evaluated and biocompatibility and bioconductivity were investigated by culturing neonatal rat CMs on the patches. In vivo, a full-thickness right ventricular outflow tract defect was created in rats and the patches were implanted. Four weeks after patch repair, cardiac electrical activation and conduction velocity were evaluated using an optical mapping system.

      Results

      In vitro, the Ppy+Chi+Gel patch had a higher mean breaking stress than the Gel or Chi+Gel patches, and the highest conductivity. None of the patches altered cell growth. The Ca2+ transient velocity of CMs cultured on the Ppy+Chi+Gel patch was 2.5-fold higher than that of CMs cultured on the Gel or Chi+Gel patches. In vivo, optical mapping at 4 weeks post-implantation demonstrated that Ppy+Chi+Gel patch-implanted hearts had faster conduction velocities, as measured on the epicardial surface. Continuous electrocardiographic telemetry did not reveal any pathologic arrhythmias after patch implantation. Ex-vivo patch conductivity testing also revealed that the Ppy+Chi+Gel patch was more conductive than the Gel and Chi+Gel patches.

      Conclusions

      The Ppy+Chi+Gel patch was biocompatible, safe and conductive, making it an attractive candidate for a new biomaterial platform for cardiac surgical repair to preserve synchronous ventricular contraction.

      Graphical Abstract

      Keywords

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