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Emergent Technologies for Cardiovascular Surgery

Journal of Donghua University(English Edition) 2017年第2期34卷 325-332页

作者： GUIDOIN Robert 于成龙李超婧 NUTLEY Mark 林婧张泽王璐 DOUVILLE Yvan Department of Surgery Laval University and Axe Regenerative MedicineResearch Centre CHU Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textile Donghua University peter lougheed centre University of Calgary

The optimal vascular blood supply throughout the body guarantees the support of normal functions to tissues and organs.Implants are now becoming a seamless extension of the body and shall accompany a higher level of fidelity between the device and the patient.As regenerative medicine is still in its infancy,the ongoing search for new and effective prosthetic alternatives continues to be essential and highly rewarding.Thanks in part to the progress of imaging and the benefits of 3D printing,previously unimagined emergent technologies are at hand.The emerging technologies of the last few decades and the near future will continue to greatly improve both the quality and quantity of patients' lives.They focus on minimally invasive technologies(keyhole surgery) and approaches for deployment of valves,stent-grafts,leadless pacemakers and adaptation of medical devices for destination therapy(assist devices and artificial hearts).In addition,specific blood conduits for the aortic valves together with the aortic arch and the pulmonary valves are considered.These breakthroughs are currently at various stages of development and acceptability.Innovative biomaterials were essential in the development of cardiovascular devices.They were and they still are the essential support for conduction prosthesis,but their place in signal prosthesis is being revisited.Any new development in medical devices has been frequently driven by surgeons and industry.The emergent technologies are introduced by pioneers.The risks and benefits of devices must be continuously reassessed during the lifetime of the implants based upon sound scientific principles of investigation,clinical experience of the users and retrieval programs.

关键词： heart valve stent graft right ventricular outflow tract(RVOT) percutaneous valve leadless pacemakers cardiovascular emergent technologies

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Fatigue Performance of Fabrics of Stent-Grafts Supported with Z-Stents vs. Ringed Stents

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Journal of Donghua University(English Edition) 2013年第5期30卷 367-370页

作者：林婧宋戈管晓宁王璐杜佳 NUTLEY Mark GUIDOIN Robert Key Laboratory of Textile Science and Technology Ministry of EducationDonghua University College of Textiles Donghua University Division of Vascular Surgery Peter Lougheed Health Center Departments of Surgery and Radiology Laval University and Québec Biomaterials Institute

Stent-grafts were commercialized rapidly and gained a broad clinical acceptance over the past two decades. However,relatively more recent recognition of particular stent-graft design shortcomings have been identified which need to be addressed. It appears that various stent-graft designs may be more or less resistant to metal fatigue and /or fabric abrasions which can lead to type III and type IV endoleaks over the long term. Therefore,it is necessary to investigate the fatigue performance of the most common stentgraft designs: Z-stents and ringed stents,in a long-term in vitro fatigue simulation environment. This paper aimed to analyze nondestructively( gross observations) and destructively( fabric characteristics,mechanical and chemical properties) in order to put forward suggestions to improve the fabric and stent characteristics that may prevent type III and IV endoleaks. The fabric supported with ringed stent-grafts remained nearly completely intact after 168h. However, the fabric supported with Z-stents demonstrated significant damage. Fabric characteristics and tensile strength of the fibers did not present a significant difference between the control and fatigue simulated specimens. The crystallinity declined for both specimens. The fatigue performance of fabrics supported with ringed stents appears to be superior to that supported with Z-stents. The potential for a dynamic and destructive interaction between the apices of Z-stents which can lead to fraying and /or tearing of the graft fabric must be addressed in future designs.

关键词： stent-graft fatigue performance fabrics Z-stents ringed stents

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Customized and in situ fenestrated stent-grafts:A reinforced poly-ε-caprolactone branch cuff designed to prevent type III endoleaks and enhance hemodynamics

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Medicine in Novel Technology and Devices 2021年第1期9卷 26-36页

作者： Fujun Wang Chaojing Li Robert Guidoin Abedalwafa Mohammed Graeham Douglas Fan Zhao Guy Dionne Ze Zhang Haripriya Ramesh Lu Wang Mark Nutley Key Laboratory of Textile Science and Technology of Ministry of Education College of TextilesDonghua UniversityShanghai201620China Axe Medecine Regeneratrice Centre de Recherche du CHUand Departments of Surgery and RadiologyUniversite LavalQuebecQCCanada Department of Engineering University of CambridgeCambridgeUK Joint Department of Biomedical Engineering UNC/NCSURaleighNCUSA Division of Vascular Surgery and Department of Diagnostic Imaging University of CalgaryPeter Lougheed CentreCalgaryABCanada

Superior long-term anchorage of the bridging stent-grafts from the fenestrated main body endograft could be achieved with the addition of a flared cuff,capable of preventing the previously observed fabric fraying around the fenestration as a result of the balloon angioplasty of the seal zone.This novel stent cuff design will also facilitate more complete biointegration of the devices,eliminate the hemodynamic variation as well as significantly reduce the possibility of a Type III endoleak.The feasibility of this concept is demonstrated by observations made from in-situ tests performed in a Beta endograft design.Flared cuffs made of poly(ε-caprolactone)supported with a weft-knitted polyester structure can be manufactured with various configurations to optimize the transition from the main body of the endograft,thus preventing the currently marketed designs’hemodynamic perturbation while also promoting endograft biointegration.This concept represents an evolution in branch graft design,which may enhance the long-term durability of customized fenestrations and open new applications for in-vivo graft fenestration in the near future.Further ongoing investigation to optimize its structure,X-ray opacity,fixation to the flared stent,and material biocompatibility are still required to build upon this concept’s proof.

关键词： Flared cuff Fenestration Stent-grafts Poly(ε-caprolactone) Polyester fabrics

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