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Endothelium-Mimicking Nanomatrix Coating to Enhance Endothelialization after Left Atrial Appendage Closure Device Implantation.
Hwang, Patrick T J; Sherwood, Jennifer A; Millican, Reid C; Bobba, Pratheek S; Lynd, Tyler O; Garner, Joseph N; Brott, Brigitta C; Hou, Dongming; Jun, Ho-Wook.
Afiliación
  • Hwang PTJ; Endomimetics, LLC, Birmingham, Alabama 35242, United States.
  • Sherwood JA; Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama 35294, United States.
  • Millican RC; Endomimetics, LLC, Birmingham, Alabama 35242, United States.
  • Bobba PS; Endomimetics, LLC, Birmingham, Alabama 35242, United States.
  • Lynd TO; Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama 35294, United States.
  • Garner JN; Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama 35294, United States.
  • Brott BC; Endomimetics, LLC, Birmingham, Alabama 35242, United States.
  • Hou D; Endomimetics, LLC, Birmingham, Alabama 35242, United States.
  • Jun HW; Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama 35294, United States.
ACS Appl Bio Mater ; 4(6): 4917-4924, 2021 06 21.
Article en En | MEDLINE | ID: mdl-35007040
Blood clots (90%) originate from the left atrial appendage (LAA) in non-valvular atrial fibrillation patients and are a major cause of embolic stroke. Long-term anticoagulation therapy has been used to prevent thrombus formation, but its use is limited in patients at a high risk for bleeding complications. Thus, left atrial appendage closure (LAAC) devices for LAA occlusion are well-established as an alternative to the anticoagulation therapy. However, the anticoagulation therapy is still required for at least 45 days post-implantation to bridge the time until complete LAA occlusion by neoendocardium coverage of the device. In this study, we applied an endothelium-mimicking nanomatrix to the LAAC device membrane for delivery of nitric oxide (NO) to enhance endothelialization, with the goal of possibly being able to reduce the duration of the anticoagulation therapy. The nanomatrix was uniformly coated on the LAAC device membranes and provided sustained release of NO for up to 1 month in vitro. In addition, the nanomatrix coating promoted endothelial cell proliferation and reduced platelet adhesion compared to the uncoated device membranes in vitro. The nanomatrix-coated and uncoated LAAC devices were then deployed in a canine LAA model for 22 days as a pilot study. All LAAC devices were not completely covered by neoendocardium 22 days post-implantation. However, histology image analysis showed that the nanomatrix-coated LAAC device had thicker neoendocardium coverage compared to the uncoated device. Therefore, our in vitro and in vivo results indicate that the nanomatrix coating has the potential to enhance endothelialization on the LAAC device membrane, which could improve patient outcomes by shortening the need for extended anticoagulation treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Apéndice Atrial / Nanoestructuras / Endotelio / Procedimientos Quirúrgicos Cardíacos Límite: Animals / Humans Idioma: En Revista: ACS Appl Bio Mater Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Apéndice Atrial / Nanoestructuras / Endotelio / Procedimientos Quirúrgicos Cardíacos Límite: Animals / Humans Idioma: En Revista: ACS Appl Bio Mater Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos