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RESEARCH ARTICLE

3D-printed poly(p-dioxanone)/graphene oxide composite bioresorbable stents for congenital heart disease treatment

 

Enrong Chen1 ,  Xiji Qin1 ,  Zhihui Xiong2* ,  Xiaorong Cai3 ,  Xuejun Jin2 ,  Kun Sun1,4* ,  Jing Sun1,4*
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1 Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
2 Institute of Medical Robotics, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
3 State Key Lab of Metal Matrix Composite, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
4 Engineering Research Center of Techniques and Instruments for Diagnosis and Treatment of Congenital Heart Disease, Ministry of Education, Shanghai, China
IJB, 4530 https://doi.org/10.36922/ijb.4530
Submitted: 15 August 2024 | Accepted: 30 September 2024 | Published: 30 September 2024
© 2024 by the Author(s).. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Bioresorbable stents (BRSs) offer significant advantages in treating congenital heart disease (CHD)-related vascular stenoses, especially for pediatric patients. However, the insufficient mechanical performance of polymeric BRSs remains a critical challenge. In this study, poly(p-dioxanone) (PPDO) was incorporated with graphene oxide (GO) for the first time to improve both mechanical properties and biocompatibility. PPDO/GO composites with varying GO content were fabricated via solution mixing and solvent casting, and tensile tests revealed that lower GO content levels (0.2% and 0.5%) significantly improved Young’s modulus, tensile strength, and elongation at break of PPDO due to hydrogen bonding and increased degree of crystallinity. 3D-printed PPDO/GO sliding-lock stents with optimal GO contents were fabricated by fused deposition modeling and demonstrated superior compression force compared to pristine PPDO stents. In vitro hemocompatibility and cytocompatibility assessments indicated that 3D-printed PPDO/GO stents exhibited a low hemolysis rate, reduced platelet adhesion, and enhanced adhesion and proliferation of endothelial cells. In vivo evaluation further demonstrated improved endothelialization in rat abdominal aortas implanted with 3D-printed PPDO/GO filaments for four weeks. Overall, PPDO/0.5%GO exhibited superior performance in compression force, hemocompatibility, cytocompatibility, and in vivo endothelialization. This study, for the first time, combines PPDO with GO and elucidates the mechanism behind the enhanced mechanical properties of PPDO/GO composite material. Using 3D printing, PPDO/GO BRSs with improved compression performance and biocompatibility were developed, highlighting their potential for treating pediatric patients with CHD-related vascular stenoses.

 

Keywords
3D printing
Bioresorbable stents
Poly(p-dioxanone)
Graphene oxide
Congenital heart disease
Funding
This work was funded by the National Natural Science Foundation of China (grant number 82300344), Shanghai Shenkang Hospital Development Center Program (grant number SHDC22021209), and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine- Shanghai Jiao Tong University Institute of Medical Robotics Joint Program (grant number 21XJMR01).
Conflict of interest
The authors declared no conflict of interest.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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