Urinary bladder matrix scaffolds promote pericardium repair in a porcine model
Authors: Natalia Amigo, Juan Martin Riganti, Mauricio Ramirez, Lorenzi Andrea, Pedro Renda, Romina Lovera, Ariel Pascaner, Carlos Vigliano, Damián Craiem, Thomas W. Gilbert, Nathaniel T. Remlinger y Alejandro Nieponice.
Abstract: Pericardium closure after cardiac surgery is recommended to prevent postoperative adhesions to the sternum. Synthetic materials have been used as substitutes, with limited results because of impaired remodeling and fibrotic tissue formation. Urinary bladder matrix (UBM) scaffolds promote constructive remodeling that more closely resemble the native tissue. The aim of the study is to evaluate the host response to UBM scaffolds in a porcine model of partial pericardial resection. Twelve Landrace pigs were subjected to a median sternotomy. A 5x7 cm pericardial defect was created and then closed with a 5x7 cm multilayer UBM patch (UBM group) or left as an open defect (control group). Animals were survived for 8 wk. End points included gross morphology, biomechanical testing, histology with semi-quantitative score, and cardiac function. The UBM group showed mild adhesions, whereas the control group showed fibrosis at the repair site, with robust adhesions and injury to the coronary bed. Load at failure (gr) and stiffness (gr/mm) were lower in the UBM group compared with the native pericardium (199.9±59.2 versus 405.3±99.89 g, P<0.0536 and 44.23±15.01 versus 146.5±4.38 g/mm, P<0.0025, respectively). In the UBM group, the histology resembled native pericardial tissue, with neovascularization, neofibroblasts, and little inflammatory signs. In contrast, control group showed fibrotic tissue with mononuclear infiltrates and a lack of organized collagen fibers validated with a histologic score. Both groups had normal ultrasonography results without cardiac motility disorders. In this setting, UBM scaffolds showed appropriate features for pericardial repair, restoring tissue properties that could help reduce postsurgical adhesions and prevent its associated complications.
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