Biogenic polymer based patches for congenital cardiac surgery: future development of implants

ObjectiveDespite advancements in surgical techniques, many patients born with congenital heart defects (CHD) require repeated reinterventions due to the limitations of materials used in congenital cardiac surgery (CCS). Traditional biogenic polymers, such as bovine or equine pericardium, are prone t...

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Main Authors: Emma Richert, Linda Grefen, Alexandra Zorin, Julian Hubrich, Stefan Simon, Christian P. Sommerhoff, Christian Hagl, Christopher Herz, Dominik Obrist, Jürgen Hörer, Thierry Carrel, Maximilian Grab, Paul Philipp Heinisch
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1540826/full
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author Emma Richert
Emma Richert
Linda Grefen
Linda Grefen
Alexandra Zorin
Julian Hubrich
Stefan Simon
Christian P. Sommerhoff
Christian Hagl
Christian Hagl
Christopher Herz
Dominik Obrist
Jürgen Hörer
Jürgen Hörer
Thierry Carrel
Maximilian Grab
Maximilian Grab
Maximilian Grab
Paul Philipp Heinisch
Paul Philipp Heinisch
author_facet Emma Richert
Emma Richert
Linda Grefen
Linda Grefen
Alexandra Zorin
Julian Hubrich
Stefan Simon
Christian P. Sommerhoff
Christian Hagl
Christian Hagl
Christopher Herz
Dominik Obrist
Jürgen Hörer
Jürgen Hörer
Thierry Carrel
Maximilian Grab
Maximilian Grab
Maximilian Grab
Paul Philipp Heinisch
Paul Philipp Heinisch
author_sort Emma Richert
collection DOAJ
description ObjectiveDespite advancements in surgical techniques, many patients born with congenital heart defects (CHD) require repeated reinterventions due to the limitations of materials used in congenital cardiac surgery (CCS). Traditional biogenic polymers, such as bovine or equine pericardium, are prone to calcification, have limited durability, and fail to adapt to the growth of infants. This study aims to address these challenges by investigating bacterial cellulose (BC) as a promising material for CCS.MethodsVariability in patch quality from previous studies was addressed by refining the production protocol taking advantage of optical density (OD) measurements. After a 72 h incubation, patches were harvested and tested mechanically with burst pressure and uniaxial strain testing. BC's biomechanical properties were further explored by modifying nutrient concentrations, creating different media groups (N10, N30, N50). Hybrid patches combining BC with electrospun polyurethane (ESP-PU) were developed using a specially designed 3D-printed flask to ensure uniform coating and integration.ResultsThe initial bacterial concentration significantly influenced cellulose yield and growth rate, with static cultures outperforming shaken ones. Nutrient-enriched media (N10, N30, N50) produced cellulose with greater elasticity and strength compared to standard C-Medium, with stiffness correlating to nutrient concentration. Inflation tests showed that N10 and N30 samples withstood higher pressures than N50, which, despite being stiffer, performed worse under rapid inflation. All samples, however, maintained pressures above physiological levels. Scanning electron microscopy analysis confirmed effective BC coating of PU fibres without altering BC fibre orientation or bacterial activity.ConclusionBC patches demonstrated burst pressure resistance above 1,400 mmHg. BC's elasticity can be tailored, and in combination with ESP-PU, an innovative hybrid material can be produced, positioning BC as a promising biomaterial for future CCS implant development.
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spelling doaj-art-681d1d4df4f949efa98f23cdc90c585a2025-08-20T02:45:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-02-011210.3389/fcvm.2025.15408261540826Biogenic polymer based patches for congenital cardiac surgery: future development of implantsEmma Richert0Emma Richert1Linda Grefen2Linda Grefen3Alexandra Zorin4Julian Hubrich5Stefan Simon6Christian P. Sommerhoff7Christian Hagl8Christian Hagl9Christopher Herz10Dominik Obrist11Jürgen Hörer12Jürgen Hörer13Thierry Carrel14Maximilian Grab15Maximilian Grab16Maximilian Grab17Paul Philipp Heinisch18Paul Philipp Heinisch19Department of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Technical University, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyGerman Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyGerman Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyGerman Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyARTORG Centre for Biomedical Engineering Research, University of Bern, Bern, SwitzerlandDepartment of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Technical University, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyChair of Medical Materials and Implants, Technical University, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyGerman Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, GermanyChair of Medical Materials and Implants, Technical University, Munich, GermanyDepartment of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Technical University, Munich, GermanyDepartment of Cardiac Surgery, LMU University Hospital, LMU, Munich, GermanyObjectiveDespite advancements in surgical techniques, many patients born with congenital heart defects (CHD) require repeated reinterventions due to the limitations of materials used in congenital cardiac surgery (CCS). Traditional biogenic polymers, such as bovine or equine pericardium, are prone to calcification, have limited durability, and fail to adapt to the growth of infants. This study aims to address these challenges by investigating bacterial cellulose (BC) as a promising material for CCS.MethodsVariability in patch quality from previous studies was addressed by refining the production protocol taking advantage of optical density (OD) measurements. After a 72 h incubation, patches were harvested and tested mechanically with burst pressure and uniaxial strain testing. BC's biomechanical properties were further explored by modifying nutrient concentrations, creating different media groups (N10, N30, N50). Hybrid patches combining BC with electrospun polyurethane (ESP-PU) were developed using a specially designed 3D-printed flask to ensure uniform coating and integration.ResultsThe initial bacterial concentration significantly influenced cellulose yield and growth rate, with static cultures outperforming shaken ones. Nutrient-enriched media (N10, N30, N50) produced cellulose with greater elasticity and strength compared to standard C-Medium, with stiffness correlating to nutrient concentration. Inflation tests showed that N10 and N30 samples withstood higher pressures than N50, which, despite being stiffer, performed worse under rapid inflation. All samples, however, maintained pressures above physiological levels. Scanning electron microscopy analysis confirmed effective BC coating of PU fibres without altering BC fibre orientation or bacterial activity.ConclusionBC patches demonstrated burst pressure resistance above 1,400 mmHg. BC's elasticity can be tailored, and in combination with ESP-PU, an innovative hybrid material can be produced, positioning BC as a promising biomaterial for future CCS implant development.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1540826/fullcongenitaltissue engineeringheart diseasepatchesinnovation
spellingShingle Emma Richert
Emma Richert
Linda Grefen
Linda Grefen
Alexandra Zorin
Julian Hubrich
Stefan Simon
Christian P. Sommerhoff
Christian Hagl
Christian Hagl
Christopher Herz
Dominik Obrist
Jürgen Hörer
Jürgen Hörer
Thierry Carrel
Maximilian Grab
Maximilian Grab
Maximilian Grab
Paul Philipp Heinisch
Paul Philipp Heinisch
Biogenic polymer based patches for congenital cardiac surgery: future development of implants
Frontiers in Cardiovascular Medicine
congenital
tissue engineering
heart disease
patches
innovation
title Biogenic polymer based patches for congenital cardiac surgery: future development of implants
title_full Biogenic polymer based patches for congenital cardiac surgery: future development of implants
title_fullStr Biogenic polymer based patches for congenital cardiac surgery: future development of implants
title_full_unstemmed Biogenic polymer based patches for congenital cardiac surgery: future development of implants
title_short Biogenic polymer based patches for congenital cardiac surgery: future development of implants
title_sort biogenic polymer based patches for congenital cardiac surgery future development of implants
topic congenital
tissue engineering
heart disease
patches
innovation
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1540826/full
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