an-intact-pericardium-ischemic-rodent-model

An Intact Pericardium Ischemic Rodent Model

This protocol has shown that the pericardium and its contents play an essential anti-fibrotic role in the ischemic rodent model (coronary ligation to ...

Cumming School of Medicine

Seeing a tree through the forest: Precision medicine tools can enhance donor allocation in heart transplantation.

Ischemic heart disease is a common cause of end-stage heart failure and has persisted as one of the main causes of end stage heart failure requiring transplantation. Maladaptive myocardial remodeling due to ischemic injury involves multiple cell types and physiologic mechanisms. Pathogenic post-infarct remodeling involves collagen deposition, chamber dilatation and ventricular dysfunction. There have been significant improvements in medication and revascularization strategies. However, despite medical optimization and opportunities to restore blood flow, physicians lack therapies that directly access and manipulate the heart to promote healthy post-infarct myocardial remodeling. Strategies are now arising that use bioactive materials to promote cardiac regeneration by promoting angiogenesis and inhibiting cardiac fibrosis; and many of these strategies leverage the unique advantage of cardiac surgery to directly visualize and manipulate the heart. Although cellular-based strategies are emerging, multiple barriers exist for clinical translation. Acellular materials have also demonstrated preclinical therapeutic potential to promote angiogenesis and attenuate fibrosis and may be able to surmount these translational barriers. Within this review we outline various acellular biomaterials and we define epicardial infarct repair and intramyocardial injection, which focus on administering bioactive materials to the cardiac epicardium and myocardium respectively to promote cardiac regeneration. In conjunction with optimized medical therapy and revascularization, these techniques show promise to upregulate pathways of cardiac regeneration to preserve heart function.

Promoting Cardiac Regeneration and Repair Using Acellular Biomaterials.

Commentary: Transplanting the powerhouse of the cell to enhance cardiopulmonary repair.

Commentary: A picture is worth a thousand words: Improving surgical approaches using advanced multimodal cardiac imaging.

Commentary: Past is Prologue - Leveraging Big Data to Optimize Future Operative Risk Prediction.

Contemporary management of ischemic heart disease lacks strategies to directly access the heart and promote reparative cellular mechanisms to improve postinfarct cardiac remodeling. Epicardial infarct repair (EIR) is an emerging technique whereby bioactive materials are sewn over ischemic areas of the heart at the time of surgical revascularization to promote adaptive cardiac repair. The CorMatrix Cor™ PATCH (CorMatrix Cardiovascular Inc., GA, USA) is an acellular bioactive material compatible with EIR. Herein, we review current preclinical and clinical data for the CorMatrix Cor PATCH and its use in EIR.

CorMatrix Cor™ PATCH for epicardial infarct repair.

Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.

Article	Year
Seeing a tree through the forest: Precision medicine tools can enhance donor allocation in heart transplantation. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 29310930	2018
Promoting Cardiac Regeneration and Repair Using Acellular Biomaterials. Frontiers in bioengineering and biotechnology\| PubMed ID: 32363184	2020
Commentary: Transplanting the powerhouse of the cell to enhance cardiopulmonary repair. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 32980149	2020
Commentary: A picture is worth a thousand words: Improving surgical approaches using advanced multimodal cardiac imaging. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 33642107	2021
Commentary: Past is Prologue - Leveraging Big Data to Optimize Future Operative Risk Prediction. Seminars in thoracic and cardiovascular surgery\| PubMed ID: 33662550	2021
CorMatrix Cor™ PATCH for epicardial infarct repair. Future cardiology\| PubMed ID: 34008420	2021
Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies. Biomolecules\| PubMed ID: 34356652	2021

Vishnu Vasanthan

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