Autologous and allogenic human pericardia used as biomaterials for cardiovascular surgery are traditionally crosslinked with glutaraldehyde. In this work, we have evaluated the resistivity to collagenase digestion and the cytotoxicity of human pericardium crosslinked with various concentrations of glutaraldehyde in comparison with pericardium crosslinked by genipin, nordihydroguaiaretic acid, tannic acid, and in comparison with unmodified pericardium. Crosslinking retained the wavy-like morphology of native pericardium visualized by second harmonic generation microscopy. The collagenase digestion products were analyzed using SDS-PAGE, capillary electrophoresis, and a hydroxyproline assay. Glutaraldehyde and genipin crosslinking protected the native pericardium efficiently against digestion with collagenase III. Only low protection was provided by the other crosslinking agents. The cytotoxicity of crosslinked pericardium was evaluated using xCELLigence by monitoring the viability of porcine valve interstitial cells cultured in eluates from crosslinked pericardium. The highest cell index, reflecting both the number and the shape of the monitored cells was observed in eluates from genipin. Crosslinking pericardium grafts with genipin therefore seems to be a promising alternative procedure to the traditional crosslinking with glutaraldehyde, because it provides similarly high protection against degradation with collagenase, without cytotoxic effects.
Péče o nemocné s vrozenými srdečními vadami má v České republice nejen významnou historii, spadající do předválečného období, ale především systematickou a dlouhodobou práci s excelentními výsledky u pediatrických pacientů. Se zlepšováním péče o tyto nemocné se také zlepšuje jejich přežívání s potřebou kontinuální péče v dospělosti včetně reoperací, katetrizačních ablací incizionálních tachykardií a dalších specializovaných výkonů ve složitém morfologickém terénu. Článek je zamyšlením a apelem na všechny zodpovědné odborníky, organizátory a plátce zdravotní péče, jak postupovat dále a zajistit specializované vzdělávání, kontinuitu péče o tyto nemocné včetně návrhu organizačních změn a nastiňuje nutnost dalšího vývoje tohoto významného oboru., Care of patients with congenital heart diseases in Czech Republic does not have only important history, falling to the prewar period, but especially systematic and long-term work with excellent results in pediatric patients. With improvements in the care of these patients also improves their survival with the need for continuous care in adulthood including reoperation, catheter ablations incisional tachycardias and other specialized procedures in difficult heart morphology. The article is a reflection and an appeal to all responsible professionals, organizers and payers of health care, how to proceed and provide specialized training, continuity of care for these patients, including proposed organizational changes and outlines the need for further development in this important medical field., and Miloš Táborský, Jana Popelová, Anna Nečasová, Jan Janoušek, Štěpán Černý, Petr Němec, Jan Pirk, Milan Šamánek