Repair of the Anterior mitral leaflet in a growing porcine model using a partially resorbable knitted patch

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ID: 328390
2026
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Ranked #105 of 146 articles by views in Interdisciplinary CardioVascular and Thoracic Surgery

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Abstract
Mitral valve repair using patch materials is frequently limited by degeneration, inflammation, and calcification, particularly in younger patients. This study evaluated the feasibility and functional durability of a partially resorbable hybrid warp-knitted bioscaffold (Synfolium, Teijin Medical Technologies, Osaka, Japan) for mitral reconstruction in a growing porcine model. In a six-month-old Danish Landrace pig (80 kg), the mitral A2 segment was replaced with a 10 × 30 mm Synfolium patch via left thoracotomy. Postoperative echocardiography demonstrated normal valve function. After 181 days, echocardiography was repeated prior to sacrifice, followed by macroscopic inspection, histological analysis, and high-resolution micro-computed tomography (micro-CT) of the explanted valve. During follow-up, the animal grew to 159 kg. Six-month echocardiography demonstrated preserved valve function with minimal regurgitation despite a 62% increase in annular diameter. Macroscopically, the patch was fully integrated and endothelialised, with no signs of structural failure. Histology demonstrated low-grade chronic inflammation confined to suture interfaces, with no fibrosis or inflammation within the patch matrix. No calcification was identified on histology or micro-CT. In this growing porcine model, mitral leaflet reconstruction using a Synfolium patch preserved valve competence and resisted calcification over six months despite substantial cardiac growth. These findings are encouraging, although repetition of the study is required to confirm the results.
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Authors J H Jedrzejczyk, M Hazekamp, M Palmen, S Nemoto, J Honge, J Hjortnaes, T D Jeppesen, J M Hasenkam, R Kraghede, J Petersen, U Sahana, C Stilling, S R Jakobsen, M Damsgaard, S S Kristiansen, K Stefani, M S Tolderlund, A D Hansen, H Lauridsen, M Pedersen, Y Fujisawa, T Motoyoshi
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Journal Interdisciplinary CardioVascular and Thoracic Surgery
Year 2026
DOI
10.1093/icvts/ivag229
URL
https://doi.org/10.1093/icvts/ivag229
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