Isaree Pitaktong, Cecillia Lui, Justin Lowenthal, Gunnar Mattson, Wei-Hung Jung, Yang Bai, Enoch Yeung, Chin Siang Ong, Yun Chen, Sharon Gerecht, and Narutoshi Hibino. 2020. “Early Vascular Cells Improve Microvascularization Within 3D Cardiac Spheroids.” Tissue engineering. Part C, Methods, 26, 2, Pp. 80-90. Publisher's VersionAbstract
Introduction: A key obstacle in the creation of engineered cardiac tissues of clinically relevant sizes is limited diffusion of oxygen and nutrients. Thus, there is a need for organized vascularization within a three-dimensional (3D) tissue environment. Human induced pluripotent stem cell (hiPSC)-derived early vascular cells (EVCs) have shown to improve organization of vascular networks within hydrogels. We hypothesize that introduction of EVCs into 3D microtissue spheroids will lead to increased microvascular formation and improve spheroid formation. Methods: HiPSC-derived cardiomyocytes (CMs) were cocultured with human adult ventricular cardiac fibroblasts (FB) and either human umbilical vein endothelial cells (HUVECs) or hiPSC-derived EVCs for 72 h to form mixed cell spheroids. Three different groups of cell ratios were tested: Group 1 (control) consisted of CM:FB:HUVEC 70:15:15, Group 2 consisted of CM:FB:EVC 70:15:15, and Group 3 consisted of CM:FB:EVC 40:15:45. Vascularization, cell distribution, and cardiac function were investigated. Results: Improved microvasculature was found in EVC spheroids with new morphologies of endothelial organization not found in Group 1 spheroids. CMs were found in a core-shell type distribution in Group 1 spheroids, but more uniformly distributed in EVC spheroids. Contraction rate increased into Group 2 spheroids compared to Group 1 spheroids. Conclusion: The triculture of CM, FB, and EVC within a multicellular cardiac spheroid promotes microvascular formation and cardiac spheroid contraction.
Chin Siang Ong, Patricia M. Brown, Pooja Yesantharao, Xun Zhou, Allen Young, Joseph K. Canner, Munirih Quinlan, Evan F. Brown, Marc S. Sussman, and Glenn J. R. Whitman. 2020. “Vasoactive and Inotropic Support, Tube Feeding, and Ischemic Gut Complications After Cardiac Surgery.” JPEN. Journal of parenteral and enteral nutrition, Pp. 10.1002/jpen.1769. Publisher's VersionAbstract
BACKGROUND: Vasoactive and inotropic support (VIS) may predispose cardiac surgery patients to ischemic gut complications (IGCx). The purpose of this study was to describe the effect of VIS on the manner in which we deliver tube feeds (TFs) and determine its relationship with IGCx in cardiac surgery patients. METHODS: We reviewed cardiac surgery patients at a single institution and examined the effect of VIS (none, low, medium, high) on TF administration and evaluated IGCx. RESULTS: Of 3088 cardiac surgery patients, 249 (8%) required TFs, comprising 2151 total TF-days. Increasing VIS was associated with decreased amounts of TF administered per day (P = .001) and an increase in time that TF was held per day (P < .001). High VIS was associated with less intact, more semi-elemental/elemental formula use (P < .001) and increased use of gastric route (P < .001). Of all cardiac surgery patients, 11 of 3125 suffered IGCx (0.4%), with a mortality of 73%. Of the 3 receiving TF, 2 IGCx were focal and consistent with acute embolus, whereas one was diffuse, on high VIS and an intra-aortic balloon pump. Of the 8 IGCx in the patients not receiving TF, 5 were focal, whereas 3 were diffuse and not embolic (P = .21). CONCLUSIONS: Despite 32% of TF-days on moderate to high VIS, non-embolic IGCx were not increased compared with patients not receiving TF. As delivered at this institution, TF in even those requiring moderate to high inotropic and pressor support were not associated with an increase in attributable IGCx.
Enoch Yeung, Takuma Fukunishi, Yang Bai, Djahida Bedja, Isaree Pitaktong, Gunnar Mattson, Anjana Jeyaram, Cecillia Lui, Chin Siang Ong, Takahiro Inoue, Hiroshi Matsushita, Sara Abdollahi, Steven M. Jay, and Narutoshi Hibino. 2019. “Cardiac regeneration using human-induced pluripotent stem cell-derived biomaterial-free 3D-bioprinted cardiac patch in vivo.” Journal of tissue engineering and regenerative medicine, 13, 11, Pp. 2031-2039. Publisher's VersionAbstract
One of the leading causes of death worldwide is heart failure. Despite advances in the treatment and prevention of heart failure, the number of affected patients continues to increase. We have recently developed 3D-bioprinted biomaterial-free cardiac tissue that has the potential to improve cardiac function. This study aims to evaluate the in vivo regenerative potential of these 3D-bioprinted cardiac patches. The cardiac patches were generated using 3D-bioprinting technology in conjunction with cellular spheroids created from a coculture of human-induced pluripotent stem cell-derived cardiomyocytes, fibroblasts, and endothelial cells. Once printed and cultured, the cardiac patches were implanted into a rat myocardial infarction model (n = 6). A control group (n = 6) without the implantation of cardiac tissue patches was used for comparison. The potential for regeneration was measured 4 weeks after the surgery with histology and echocardiography. 4 weeks after surgery, the survival rates were 100% and 83% in the experimental and the control group, respectively. In the cardiac patch group, the average vessel counts within the infarcted area were higher than those within the control group. The scar area in the cardiac patch group was significantly smaller than that in the control group. (Figure S1) Echocardiography showed a trend of improvement of cardiac function for the experimental group, and this trend correlated with increased patch production of extracellular vesicles. 3D-bioprinted cardiac patches have the potential to improve the regeneration of cardiac tissue and promote angiogenesis in the infarcted tissues and reduce the scar tissue formation.
Chin Siang Ong, James A. Marcum, Kenton J. Zehr, and Duke E. Cameron. 2019. “A Century of Heparin.” The Annals of thoracic surgery, 108, 3, Pp. 955-958. Publisher's VersionAbstract
The year 2018 was the centennial of the naming of heparin by Emmett Holt and William Howell and the 102nd anniversary of Jay McLean's discovery of an anticoagulant heparphosphatide at Johns Hopkins Hospital in Baltimore. This article discusses recently discovered historical artifacts that shed new light on heparin's christening, including McLean's unpublished letter written in 1950 that represents one of the most complete accounts of heparin's discovery before his untimely death. In addition, the article describes the finding of a plaque dedicated to McLean and explores the circumstances of its removal from public display, as learned from interviews with present and former staff members.
Takuma Fukunishi, Chin Siang Ong, Pooja Yesantharao, Cameron A. Best, Tai Yi, Huaitao Zhang, Gunnar Mattson, Joseph Boktor, Kevin Nelson, Toshiharu Shinoka, Christopher K. Breuer, Jed Johnson, and Narutoshi Hibino. 2019. “Different degradation rates of nanofiber vascular grafts in small and large animal models.” Journal of tissue engineering and regenerative medicine, Pp. 10.1002/term.2977. Publisher's VersionAbstract
Nanofiber vascular grafts have been shown to create neovessels made of autologous tissue, by in vivo scaffold biodegradation over time. However, many studies on graft materials and biodegradation have been conducted in vitro or in small animal models, instead of large animal models, which demonstrate different degradation profiles. In this study, we compared the degradation profiles of nanofiber vascular grafts in a rat model and a sheep model, while controlling for the type of graft material, the duration of implantation, fabrication method, type of circulation (arterial/venous), and type of surgery (interposition graft). We found that there was significantly less remaining scaffold (i.e., faster degradation) in nanofiber vascular grafts implanted in the sheep model compared with the rat model, in both the arterial and the venous circulations, at 6?months postimplantation. In addition, there was more extracellular matrix deposition, more elastin formation, more mature collagen, and no calcification in the sheep model compared with the rat model. In conclusion, studies comparing degradation of vascular grafts in large and small animal models remain limited. For clinical translation of nanofiber vascular grafts, it is important to understand these differences.
Chen Yu Huang, Rebeca Peres Moreno Maia-Joca, Chin Siang Ong, Ijala Wilson, Deborah DiSilvestre, Gordon F. Tomaselli, and Daniel H. Reich. 2019. “Enhancement of human iPSC-derived cardiomyocyte maturation by chemical conditioning in a 3D environment.” Journal of molecular and cellular cardiology, 138, Pp. 1-11. Publisher's VersionAbstract
Recent advances in the understanding and use of pluripotent stem cells have produced major changes in approaches to the diagnosis and treatment of human disease. An obstacle to the use of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) for regenerative medicine, disease modeling and drug discovery is their immature state relative to adult myocardium. We show the effects of a combination of biochemical factors, thyroid hormone, dexamethasone, and insulin-like growth factor-1 (TDI) on the maturation of hiPSC-CMs in 3D cardiac microtissues (CMTs) that recapitulate aspects of the native myocardium. Based on a comparison of the gene expression profiles and the structural, ultrastructural, and electrophysiological properties of hiPSC-CMs in monolayers and CMTs, and measurements of the mechanical and pharmacological properties of CMTs, we find that TDI treatment in a 3D tissue context yields a higher fidelity adult cardiac phenotype, including sarcoplasmic reticulum function and contractile properties consistent with promotion of the maturation of hiPSC derived cardiomyocytes.
Takuma Fukunishi, Chin Siang Ong, Cecillia Lui, Isaree Pitaktong, Carissa Smoot, Jeremy Harris, Peter Gabriele, Luca Vricella, Lakshmi Santhanam, Steven Lu, and Narutoshi Hibino. 2019. “Formation of Neoarteries with Optimal Remodeling Using Rapidly Degrading Textile Vascular Grafts.” Tissue engineering. Part A, 25, 7-8, Pp. 632-641. Publisher's VersionAbstract
We utilized innovative textile technology to create tissue-engineered vascular grafts (TEVGs) comprised exclusively of rapidly degrading material poly(glycolic acid). Our new technology led to robust neotissue formation in the TEVGs, especially extracellular matrix formation, such as elastin. In addition, the rapid degradation of the polymer significantly reduced complications, such as stenosis or calcification, as seen with the use of slow degrading polymers in the majority of previous studies for aortic small diameter TEVGs.
Bai Yang, Cecillia Lui, Enoch Yeung, Hiroshi Matsushita, Anjana Jeyaram, Isaree Pitaktong, Takahiro Inoue, Zayneb Mohamed, Chin Siang Ong, Deborah DiSilvestre, Steven M. Jay, Leslie Tung, Gordon Tomaselli, Chunye Ma, and Narutoshi Hibino. 2019. “A Net Mold-Based Method of Biomaterial-Free Three-Dimensional Cardiac Tissue Creation.” Tissue engineering. Part C, Methods, 25, 4, Pp. 243-252. Publisher's VersionAbstract
Ischemic cardiomyopathy poses a significant public health burden due to the irreversible loss of functional cardiac tissue. Alternative treatment strategies include creation of three-dimensional (3D) cardiac tissues to both replace and augment injured native tissue. In this study, we utilize a net mold-based method to create a biomaterial-free 3D cardiac tissue and compare it to current methods using biomaterials. Cardiomyocytes, fibroblasts, and endothelial cells were combined using a hanging drop method to create spheroids. For the net mold patch method, spheroids were seeded into a net mold-based system to create biomaterial-free 3D cardiac patches. For the gel patch, spheroids were embedded in a collagen gel. Immunohistochemistry revealed increased alignment, vascularization, collagen I expression, cell viability, and higher density of cells in the net mold patch compared with the gel patch. Furthermore, in vivo testing in a left anterior descending artery ligation rat model found increased ejection fraction and smaller scar area following implantation of the net mold patch. We present a novel and simple reproducible method to create biomaterial-free 3D net mold patches that may potentially improve the treatment of heart failure in the future.
Ravi Medikonda, Chin Siang Ong, Rajeev Wadia, Dheeraj Goswami, Jamie Schwartz, Larry Wolff, Narutoshi Hibino, Luca Vricella, Daniel Nyhan, Viachaslau Barodka, and Jochen Steppan. 2019. “Trends and Updates on Cardiopulmonary Bypass Setup in Pediatric Cardiac Surgery.” Journal of cardiothoracic and vascular anesthesia, 33, 10, Pp. 2804-2813. Publisher's VersionAbstract
Perfusion strategies for cardiopulmonary bypass have direct consequences on pediatric cardiac surgery outcomes. However, inconsistent study results and a lack of uniform evidence-based guidelines for pediatric cardiopulmonary bypass management have led to considerable variability in perfusion practices among, and even within, institutions. Important aspects of cardiopulmonary bypass that can be optimized to improve clinical outcomes of pediatric patients undergoing cardiac surgery include extracorporeal circuit components, priming solutions, and additives. This review summarizes the current literature on circuit components and priming solution composition with an emphasis on crystalloid, colloid, and blood-based primes, as well as mannitol, bicarbonate, and calcium.
Chin Siang Ong, Lucy Nam, Kingsfield Ong, Aravind Krishnan, Chen Yu Huang, Takuma Fukunishi, and Narutoshi Hibino. 2018. “3D and 4D Bioprinting of the Myocardium: Current Approaches, Challenges, and Future Prospects.” BioMed research international, 2018, Pp. 6497242-6497242. Publisher's VersionAbstract
3D and 4D bioprinting of the heart are exciting notions in the modern era. However, myocardial bioprinting has proven to be challenging. This review outlines the methods, materials, cell types, issues, challenges, and future prospects in myocardial bioprinting. Advances in 3D bioprinting technology have significantly improved the manufacturing process. While scaffolds have traditionally been utilized, 3D bioprinters, which do not require scaffolds, are increasingly being employed. Improved understanding of the cardiac cellular composition and multiple strategies to tackle the issues of vascularization and viability had led to progress in this field. In vivo studies utilizing small animal models have been promising. 4D bioprinting is a new concept that has potential to advance the field of 3D bioprinting further by incorporating the fourth dimension of time. Clinical translation will require multidisciplinary collaboration to tackle the pertinent issues facing this field.
Chin Siang Ong, Pooja Yesantharao, Chen Yu Huang, Gunnar Mattson, Joseph Boktor, Takuma Fukunishi, Huaitao Zhang, and Narutoshi Hibino. 2018. “3D bioprinting using stem cells.” Pediatric research, 83, 1-2, Pp. 223-231. Publisher's VersionAbstract
Recent advances have allowed for three-dimensional (3D) printing technologies to be applied to biocompatible materials, cells and supporting components, creating a field of 3D bioprinting that holds great promise for artificial organ printing and regenerative medicine. At the same time, stem cells, such as human induced pluripotent stem cells, have driven a paradigm shift in tissue regeneration and the modeling of human disease, and represent an unlimited cell source for tissue regeneration and the study of human disease. The ability to reprogram patient-specific cells holds the promise of an enhanced understanding of disease mechanisms and phenotypic variability. 3D bioprinting has been successfully performed using multiple stem cell types of different lineages and potency. The type of 3D bioprinting employed ranged from microextrusion bioprinting, inkjet bioprinting, laser-assisted bioprinting, to newer technologies such as scaffold-free spheroid-based bioprinting. This review discusses the current advances, applications, limitations and future of 3D bioprinting using stem cells, by organ systems.
Sarah A. Chen, Chin Siang Ong, Nagina Malguria, Luca A. Vricella, Juan R. Garcia, and Narutoshi Hibino. 2018. “Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training.” World journal for pediatric & congenital heart surgery, 9, 4, Pp. 454-458. Publisher's VersionAbstract
PURPOSE: Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. DESCRIPTION: Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. EVALUATION: Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. CONCLUSIONS: Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.
Chin Siang Ong, Xun Zhou, Jingnan Han, Chen Yu Huang, Andrew Nashed, Shipra Khatri, Gunnar Mattson, Takuma Fukunishi, Huaitao Zhang, and Narutoshi Hibino. 2018. “In vivo therapeutic applications of cell spheroids.” Biotechnology advances, 36, 2, Pp. 494-505. Publisher's VersionAbstract
Spheroids are increasingly being employed to answer a wide range of clinical and biomedical inquiries ranging from pharmacology to disease pathophysiology, with the ultimate goal of using spheroids for tissue engineering and regeneration. When compared to traditional two-dimensional cell culture, spheroids have the advantage of better replicating the 3D extracellular microenvironment and its associated growth factors and signaling cascades. As knowledge about the preparation and maintenance of spheroids has improved, there has been a plethora of translational experiments investigating in vivo implantation of spheroids into various animal models studying tissue regeneration. We review methods for spheroid delivery and how they have been utilized in tissue engineering experiments. We break down efforts in this field by organ systems, discussing applications of spheroids to various animal models of disease processes and their potential clinical implications. These breakthroughs have been made possible by advancements in spheroid formation, in vivo delivery and assessment. There is unexplored potential and room for further research and development in spheroid-based tissue engineering approaches. Regenerative medicine and other clinical applications ensure this exciting area of research remains relevant for patient care.
Yang Bai, Enoch Yeung, Cecillia Lui, Chin Siang Ong, Isaree Pitaktong, Chen Yu Huang, Takahiro Inoue, Hiroshi Matsushita, Chunye Ma, and Narutoshi Hibino. 2018. “A Net Mold-based Method of Scaffold-free Three-Dimensional Cardiac Tissue Creation.” Journal of visualized experiments : JoVE, 138, Pp. 58252. Publisher's VersionAbstract
This protocol describes a novel and easy net mold-based method to create three-dimensional (3-D) cardiac tissues without additional scaffold material. Human-induced pluripotent stem-cell-derived cardiomyocytes (iPSC-CMs), human cardiac fibroblasts (HCFs), and human umbilical vein endothelial cells (HUVECs) are isolated and used to generate a cell suspension with 70% iPSC-CMs, 15% HCFs, and 15% HUVECs. They are co-cultured in an ultra-low attachment "hanging drop" system, which contains micropores for condensing hundreds of spheroids at one time. The cells aggregate and spontaneously form beating spheroids after 3 days of co-culture. The spheroids are harvested, seeded into a novel mold cavity, and cultured on a shaker in the incubator. The spheroids become a mature functional tissue approximately 7 days after seeding. The resultant multilayered tissues consist of fused spheroids with satisfactory structural integrity and synchronous beating behavior. This new method has promising potential as a reproducible and cost-effective method to create engineered tissues for the treatment of heart failure in the future.
Kingsfield Ong, Chin Siang Ong, Yang Chong Chua, Ali Akbar Fazuludeen, and Aneez Dokeu Basheer Ahmed. 2018. “The painless combination of anatomically contoured titanium plates and porcine dermal collagen patch for chest wall reconstruction.” Journal of thoracic disease, 10, 5, Pp. 2890-2897. Publisher's VersionAbstract
BACKGROUND: A plethora of new biomaterials and dedicated rib fixator implant systems have been introduced into the field of chest wall reconstruction. The aim of our study is to evaluate the surgical outcomes of a novel combination of the anatomically contoured titanium rib implant and porcine dermal collagen patch for chest wall reconstruction. METHODS: We performed a retrospective review of eight consecutive patients who underwent chest wall resection and reconstruction between January 2014 to August 2015 in a single institution. MatrixRib Fixation System and Permacol Surgical Implant were utilized to achieve chest wall reconstruction. RESULTS: The indication for reconstruction was malignant infiltration in 50% of patients. Three other subjects (37.5%) had chest wall resections to achieve adequate and safe surgical exposure. One patient had a right lung apical mycetoma with chest wall invasion. All patients underwent lung resections with the removal of 2 to 6 (median 3) ribs. Reconstruction was performed using the MatrixRib system, with a median of 2.5 (range, 2-4) ribs fixed in each patient. There was no post-operative mortality. One patient had a superficial wound infection which resolved with one week of oral antibiotics. Upon discharge, the pain scores were near zero with minimal analgesic requirements. None of the patients required repeat surgery or removal of their implants. CONCLUSIONS: Our early experience indicates that the combination of the MatrixRib system and Permacol patch for chest wall reconstruction is safe and feasible with promising results in terms of anatomical restoration of the chest wall mechanics, infection and pain.
Ravi Medikonda, Chin Siang Ong, Rajeev Wadia, Dheeraj Goswami, Jamie Schwartz, Larry Wolff, Narutoshi Hibino, Luca Vricella, Viachaslau Barodka, and Jochen Steppan. 2018. “A Review of Goal-Directed Cardiopulmonary Bypass Management in Pediatric Cardiac Surgery.” World journal for pediatric & congenital heart surgery, 9, 5, Pp. 565-572. Publisher's VersionAbstract
Cardiopulmonary bypass perfusion management significantly affects postoperative outcomes. In recent years, the principles of goal-directed therapy have been applied to the field of cardiothoracic surgery to improve patient outcomes. Goal-directed therapy involves continuous peri- and postoperative monitoring of vital clinical parameters to tailor perfusion to each patient's specific needs. Closely measured parameters include fibrinogen, platelet count, lactate, venous oxygen saturation, central venous oxygen saturation, mean arterial pressure, perfusion flow rate, and perfusion pulsatility. These parameters have been shown to influence postoperative fresh frozen plasma transfusion rate, coagulation state, end-organ perfusion, and mortality. In this review, we discuss the recent paradigm shift in pediatric perfusion management toward goal-directed perfusion.
Rui Han Liu, Chin Siang Ong, Takuma Fukunishi, Kingsfield Ong, and Narutoshi Hibino. 2018. “Review of Vascular Graft Studies in Large Animal Models.” Tissue engineering. Part B, Reviews, 24, 2, Pp. 133-143. Publisher's VersionAbstract
As the incidence of cardiovascular disease continues to climb worldwide, there is a corresponding increase in demand for surgical interventions involving vascular grafts. The current gold standard for vascular grafts is autologous vessels, an option often excluded due to disease circumstances. As a result, many patients must resort to prosthetic options. While widely available, prosthetic grafts have been demonstrated to have inferior patency rates compared with autologous grafts due to inflammation and thrombosis. In an attempt to overcome these limitations, many different materials for constructing vascular grafts, from modified synthetic nondegradable polymers to biodegradable polymers, have been explored, many of which have entered the translational stage of research. This article reviews these materials in the context of large animal models, providing an outlook on the preclinical potential of novel biomaterials as well as the future direction of vascular graft research.
Takuma Fukunishi, Cameron A. Best, Chin Siang Ong, Tyler Groehl, James Reinhardt, Tai Yi, Hideki Miyachi, Huaitao Zhang, Toshiharu Shinoka, Christopher K. Breuer, Jed Johnson, and Narutoshi Hibino. 2018. “Role of Bone Marrow Mononuclear Cell Seeding for Nanofiber Vascular Grafts.” Tissue engineering. Part A, 24, 1-2, Pp. 135-144. Publisher's VersionAbstract
{OBJECTIVE: Electrospinning is a promising technology that provides biodegradable nanofiber scaffolds for cardiovascular tissue engineering. However, success with these materials has been limited, and the optimal combination of scaffold parameters for a tissue-engineered vascular graft (TEVG) remains elusive. The purpose of the present study is to evaluate the effect of bone marrow mononuclear cell (BM-MNC) seeding in electrospun scaffolds to support the rational design of optimized TEVGs. METHODS: Nanofiber scaffolds were fabricated from co-electrospinning a solution of polyglycolic acid and a solution of poly(i-lactide-co-e-caprolactone) and characterized with scanning electron microscopy. Platelet activation and cell seeding efficiency were assessed by ATP secretion and DNA assays, respectively. Cell-free and BM-MNC seeded scaffolds were implanted in C57BL/6 mice (n = 15/group) as infrarenal inferior vena cava (IVC) interposition conduits. Animals were followed with serial ultrasonography for 6 months, after which grafts were harvested for evaluation of patency and neotissue formation by histology and immunohistochemistry (n = 10/group) and PCR (n = 5/group) analyses. RESULTS: BM-MNC seeding of electrospun scaffolds prevented stenosis compared with unseeded scaffolds (seeded: 9/10 patent vs. unseeded: 1/10 patent
Chin Siang Ong, Aravind Krishnan, Chen Yu Huang, Philip Spevak, Luca Vricella, Narutoshi Hibino, Juan R. Garcia, and Lasya Gaur. 2018. “Role of virtual reality in congenital heart disease.” Congenital heart disease, 13, 3, Pp. 357-361. Publisher's VersionAbstract
OBJECTIVE: New platforms for patient imaging present opportunities for improved surgical planning in complex congenital heart disease (CHD). Virtual reality (VR) allows for interactive manipulation of high-resolution representations of patient-specific imaging data, as a supplement to traditional 2D visualizations and 3D printed heart models. DESIGN: We present the novel use of VR for the presurgical planning of cardiac surgery in two infants with complex CHD to demonstrate interactive real-time views of complex intra and extracardiac anatomy. RESULTS: The use of VR for cardiac presurgical planning is feasible using existing imaging data. The software was evaluated by both pediatric cardiac surgeons and pediatric cardiologists, and felt to be reliable and operated with a very short learning curve. CONCLUSIONS: VR with controller-based interactive capability allows for interactive viewing of 3D models with complex intra and extracardiac anatomy. This serves as a useful complement to traditional preoperative planning methods in terms of its potential for group based collaborative discussion, user defined illustrative views, cost-effectiveness, and facility of use.
Chin Siang Ong, Duke E. Cameron, and Marshall L. Jacobs. 2018. “Surgical management of anomalous coronary arteries.” Annals of cardiothoracic surgery, 7, 5, Pp. 604-610. Publisher's VersionAbstract
Anomalies in the coronary arterial circulation have been described since classical antiquity by Galen and through the Medical Renaissance by Vesalius, but their clinical significance and association with sudden cardiac death (SCD) has only been appreciated over the last 4 decades. Advances in cardiac surgery and cardiovascular intensive care have led to decreasing overall postoperative mortality and morbidity associated with cardiac surgery. The decision whether to surgically treat an anomaly of coronary artery origin and course, and the risk-to-benefit ratio of surgical treatment in preventing a potentially lethal complication of SCD, requires careful, deliberate consideration based on the best available evidence. In this keynote lecture, we aim to deliver a concise discussion of the current surgical management of anomalous coronary arteries.