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Pre-clinical study finds SIS vascular patch could decrease repeated surgeries in children with congenital heart disease

Congenital heart disease (CHD) is the leading cause of birth-defect associated infant deaths.

Currently, severe cases require surgery with implantation of synthetic blood vessels. Not only are these cases often complicated and of high risk to the patient, the surgeries must be repeated as the infant grows because the synthetic vessel transplants do not grow with the child.

Dr. Daniel Swartz’s group at The State University of New York, Buffalo, has been developing fully resorbable tissue-engineered blood vessels (TEBVs) that they hope will replace the non-resorbable synthetic vessels currently used. Their strategy is to add specific molecules to the internal surface of tubes created from small intestinal submucosa (SIS). SIS is commercially available as a vascular patch (Aziyo Biologics’ VasCure®) manufactured by Cook Biotech.

The molecules Dr. Swartz’s team added, heparin and vascular endothelial growth factor (VEGF), prevent blood clotting and attract blood vessel cells. In their latest publication,1 they implanted TEBVs into young lambs’ carotid arteries; while not a model specifically of CHD, lambs are well studied as a preclinical model for pediatric cardiovascular research.2 Dr. Swartz’s team found that the TEBVs grew in diameter and length in a manner similar to the animals’ own vessels. In addition, by 6 months the TEBVs had the same components and only slightly less strength than the animals’ own vessels.*

The research by Dr. Swartz’s team has the potential to greatly impact pediatric cardiac surgery as it suggests that these off-the-shelf TEBVs may be able to grow with the patient, decreasing the need for multiple sequential surgeries in children with congenital heart disease.

* Six months in lambs is similar to five years in humans.1

1 Nasiri B, Row S, Smith RJ Jr, Swartz DD, Andreadis ST. Cell-free vascular grafts that grow with the host. Adv Funct Mater. 2020;30(48):2005769.

2 Carney EL, Clark JB, Myers JL, Peterson R, Wilson RP, Weiss WJ. Animal model development for the Penn State Pediatric Ventricular Assist Device. Artif Organs. 2009;33(11):953-957.