Construction and Evaluation of a Bio-Engineered Pump to Enable Subpulmonary Support of the Fontan Circulation: A Proof-of-Concept Study. Issue 8 (1st December 2021)

• Record Type: Journal Article
• Authors: Broda, Christopher R.; Smith, P. Alex; Wang, Yaxin; Sriraman, Hamsini; Owuor, Peter S.; Sampaio, Luiz C.; Adachi, Iki; Taylor, Doris A.
• Is Part Of: ASAIO journal. Volume 68:Issue 8(2022)
• Page Start: 1063
• Page End: 1070
• Publication Date: 2021-12-01
• Subjects: single ventricle -- Fontan circulation -- total cavopulmonary connection -- assist device -- subpulmonary support -- extracellular matrix; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000001617
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Our objective was to create a bio-engineered pump (BEP) for subpulmonary Fontan circulation support capable of luminal endothelialization and producing a 2–6 mmHg pressure gradient across the device without flow obstruction. To accomplish this, porcine urinary bladder submucosa was decellularized to produce a urinary bladder matrix (UBM) which produced acellular sheets of UBM. The UBM was cultured with human umbilical vein endothelial cells producing a nearly confluent monolayer of cells with the maintenance of typical histologic features demonstrating UBM to be a suitable substrate for endothelial cells. A lamination process created bilayer UBM sheets which were formed into biologic reservoirs. BEPs were constructed by securing the biologic reservoir between inlet and outlet valves and compressed with a polyurethane balloon. BEP function was evaluated in a simple flow loop representative of a modified subpulmonary Fontan circulation. A BEP with a 92-mL biologic reservoir operating at 60 cycles per minute produced pulsatile downstream flows without flow obstruction and generated a favorable pressure gradient across the device, maintaining upstream pressure of 6 mm Hg and producing downstream pressure of 13 mm Hg. The BEP represents potential long-term assistance for the Fontan circulation to relieve venous hypertension, provide pulsatile pulmonary blood flow and maintain cardiac preload.