Introduction:
The non-biodegradable material-made “Corecap” type cardiac support device reportedly reduces diastolic wall stress and consequently improves systolic cardiac function. However, the efficacy was inconsistent in the clinical studies possibly due to device-related impairment of diastolic cardiac function. We herein hypothesized that use of biodegradable material for the cardiac support device may contribute to improvement in both systolic and diastolic function of the failing heart.
Methods:
Polyglycolic acid and Polyethyleneterephtalate were used to prepare biodegradable (n=6) and non-biodegradable (n=5) cardiac support device, respectively. Both cardiac support devices were structurally designed to cover the entire ventricles of the 12-month-aged Beagle canine heart that was subjected to anterior coronary artery ligation at 1 week prior to the implantation. Sham operation was performed in coronary artery-ligated canines for control (n=7).
Results:
At 12 weeks after coronary artery ligation, the biodegradable group showed a greater recovery of ejection fraction than the non-biodegradable and the control group (39 ± 4% vs. 31 ± 4% vs. 30± 3, respectively, P <0.05), assessed by multi-detector computed tomography. Echocardiographically, diastolic function evaluated by Doppler-derived mitral deceleration time at 12 weeks was significantly greater in the biodegradable group (108 ± 18 msec) than the non-biogradable group (70 ± 13 msec, P<0.05). Thickness of connective tissues around the epicardium was significantly less in the biodegradable groups than the non-biodegradable group at 12 weeks. Histologically, fibrosis in the infarct area was significantly less in the treatment groups than the control group.
Conclusions:
Implantation of cardiac support device made of biodegradable material was effective in improvement of both systolic and diastolic function of the canine infarct heart for 12 weeks, compared with that of non-biodegradable material, warranting clinical studies using biodegradable cardiac support device.
Biodegradable vs Nonbiodegradable Cardiac Support Device for Treating Ischemic Cardiomyopathy in a Canine Heart
