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Design and Simulation of the Biomechanics of Multi-Layered Composite Poly(Vinyl Alcohol) Coronary Artery Grafts

ABSTRACT: Coronary artery disease is among the primary causes of death worldwide. While synthetic grafts allow replacement of diseased tissue, mismatched mechanical properties between graft and native tissue remains a major cause of graft failure. Multi-layered grafts could overcome these mechanical incompatibilities by mimicking the structural heterogeneity of the artery wall. However, the layer-specific biomechanics of synthetic grafts under physiological conditions and their impact on endothelial function is often overlooked and/or poorly understood. In this study, the transmural biomechanics of four synthetic graft designs were simulated under physiological pressure, relative to the coronary artery wall, using finite element analysis. Using poly(vinyl alcohol) (PVA)/gelatin cryogel as the representative biomaterial, the following conclusions are drawn: (I) the maximum circumferential stress occurs at the luminal surface of both the grafts and the artery; (II) circumferential stress varies discontinuously across the media and adventitia, and is influenced by the stiffness of the adventitia; (III) unlike native tissue, PVA/gelatin does not exhibit strain stiffening below diastolic pressure; and (IV) for both PVA/gelatin and native tissue, the magnitude of stress and strain distribution is heavily dependent on the constitutive models used to model material hyperelasticity. While these results build on the current literature surrounding PVA-based arterial grafts, the proposed method has exciting potential toward the wider design of multi-layer scaffolds. Such finite element analyses could help guide the future validation of multi-layered grafts for the treatment of coronary artery disease.

SUBMITTER: Fegan K

PROVIDER: S-EPMC9272978 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Synthetic small diameter vascular grafts with mechanical properties of native arteries, resistance to thrombosis and capacity to stimulate in situ endothelialization are an unmet clinical need. Poly(vinyl alcohol) hydrogel (PVA) is an excellent candidate as a vascular graft due to its tunable mechanical properties. However, the hydrophilicity and bio-inertness of PVA prevents endothelialization in vivo. We hypothesize that the modification of PVA with biomolecules and topographies creates a hemocompatible environment that also enhances bioactivity. PVA modified with fibronectin, RGDS peptide, cyclicRGD (cRGD) peptide, or heparin provided cell-adhesion motifs, which were confirmed by detection of nitrogen through X-ray photoelectron spectroscopy. Protein- and peptide-modified surfaces showed a slight increase in human vascular endothelial cell proliferation over unmodified PVA. With the exception of fibronectin modification, modified surfaces showed in vitro hemocompatibility comparable with unmodified PVA. To further improve bioactivity, cRGD-PVA was combined with gratings and microlens topographies. Combined modifications of 2 ?m gratings or convex topography and cRGD significantly improved human vascular endothelial cell viability on PVA. In vitro hemocompatibility testing showed that topography on cRGD-PVA did not significantly trigger an increase of platelet adhesion or activation compared with unpatterned PVA. Using the more physiologically relevant ex vivo hemocompatibility testing, all PVA grafts tested showed similar platelet adhesion to ePTFE and significantly lower platelet accumulation compared to collagen-coated ePTFE grafts. The biochemical and topographical modification of PVA demonstrates excellent hemocompatibility with enhanced bioactivity of PVA, thus highlighting its potential as a vascular graft.New synthetic small diameter vascular grafts with mechanical properties, blood-clot resistance and endothelial lining mimicking native arteries remains an unresolved critical clinical need. We aim to achieve this by modifying the mechanically-tunable poly(vinyl alcohol) hydrogel (PVA) vascular graft with both biochemical and biophysical cues in the lumenal surface. PVA modified with cyclic RGD peptide and ordered micrometer-sized topography showed low platelet adhesion in both a rabbit in vitro and baboon ex vivo blood compatibility assay. Modified PVA also exhibited significant enhancement of human vascular endothelial cell viability and proliferation in vitro. The readily available, modified PVA grafts are the first to show biophysical and biochemical modification in a three-dimensional scaffold with hemocompatibility, biofunctionality and excellent potential for clinical application.

Project description:Controlled delivery of hydrophilic proteins is an important therapeutic strategy. However, widely used methods for protein delivery suffer from low incorporation efficiency and loss of bioactivity. The versatile interfacial polyelectrolyte complexation (IPC) fibers have the capacity for precise spatiotemporal release and protection of protein, growth factor, and cell bioactivity. Yet its weak mechanical properties limit its application and translation into a viable clinical solution. To overcome this limitation, IPC fibers can be incorporated into polymeric scaffolds such as the biocompatible poly(vinyl alcohol) hydrogel (PVA). Therefore, we explored the use of a composite scaffold of PVA and IPC fibers for controlled biomolecule release. We first observed that the permeability of biomolecules through PVA films were dependent on molecular weight. Next, IPC fibers were incorporated in between layers of PVA to produce PVA-IPC composite scaffolds with different IPC fiber orientation. The composite scaffold demonstrated excellent mechanical properties and efficient biomolecule incorporation. The rate of biomolecule release from PVA-IPC composite grafts exhibited dependence on molecular weight, with lysozyme showing near-linear release for 1?month. Angiogenic factors were also incorporated into the PVA-IPC grafts, as a potential biomedical application of the composite graft. While vascular endothelial growth factor only showed a maximum cumulative release of 3%, the smaller PEGylated-QK peptide showed maximum release of 33%. Notably, the released angiogenic biomolecules induced endothelial cell activity thus indicating retention of bioactivity. We also observed lack of significant macrophage response against PVA-IPC grafts in a rabbit model. Showing permeability, mechanical strength, precise temporal growth factor release, and bioinertness, PVA-IPC fibers composite scaffolds are excellent scaffolds for controlled biomolecule delivery in soft tissue engineering.

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Design and Simulation of the Biomechanics of Multi-Layered Composite Poly(Vinyl Alcohol) Coronary Artery Grafts

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