Coronary-Based Right Heart Flap Recellularization by Rat Neonatal Whole Cardiac Cells: a Viable Sheep Cardiac Patch Model for Possible Management of Heart Aneurysm

Purpose To develop decellularized coronary-based right heart flaps by perfusion-based method followed by recellularization with rats’ neonatal green fluorescent protein (GFP)-positive cardiac cells. Methods Right heart was dissected from ovine heart and decellularized through right coronary by sodium dodecyl sulfate (SDS) perfusion. The efficacy of the decellularization procedure was evaluated by several studies. In vitro recellularization of flaps was performed using rats’ neonatal positive cardiac cells after in vitro cell culture. Histological evaluations were performed for in vitro recellularized samples. Results The perfusion-based decellularization method using SDS was a promising decellularization approach. These scaffolds were validated in terms of preservation of the tissue architecture, stable collagen, sulfated glycosaminoglycan (sGAGs) concentration, and intact biomechanical integrity. In vitro recellularized flap scaffolds had well-organized structure confirmed with histological evaluations. Immunohistochemistry images showed confluent coverage of fibroblast, cardiomyocyte, endothelial, and smooth muscle cells on the decellularized myocardial flap. The results of immunofluorescence (IF) microscopy authenticated that GFP-positive cardiomyocytes were successfully seeded on the empty flaps after 20 days in a bioreactor. Conclusion In vitro recellularization of cardiac flap scaffolds with GFP positive cardiac cells signifies an attractive approach to prevent the rupture of aneurysm following myocardial infarction (MI) by restoring coronary patch perfusion and revascularization of seeded graft by coronary artery bypass graft (CABG) technique. Lay summary Previously, we evaluated the histological aspects of a decellularized whole ovine heart scaffold through coronary perfusion, and we also assessed in situ recellularization by hetrotopic transplantation into the omental wrap. In this study, we try to develop decellularized coronary-based right heart flaps by perfusion-based method. We also aim to perform in vitro recellularization of cardiac flap scaffolds with GFP-positive cardiac cells