The use of Bioresorbable Scaffolds in Cardiovascular Surgery

The bioresorbable scaffolds are becoming progressively and increasingly evaluated in the practice of interventional cardiology [1,2]. They were initially developed to overcome limitations of drug eluting stents, which produce chronic local inflammation due to the permanent implantation of a foreign body, the restriction of vascular compliance, the impaired vasomotory properties due to a metal cage, and the risk of late thrombosis. Thus it became appearent the need to introduce in clinical practice a system which allows an early structural support and then dissolves over time, restoring pulsatility, cyclical strain, physiological shear stress, and mechanotransduction to the treated vessel, which ultimately resembles a native conduit [2]. The production of smart scaffolds simulating the biological assets of the natural extracellular matrix and promoting autologous stem cell growth and differentiation would allow to explore the endogenous regenerative resources avoiding the technical, financial and ethical concerns which are associated with the use of homologous stem cells [3,4]. In fact, these bioresorbable scaffolds may be used as a structural support, which might be colonized by autologous cells after the implantation and guide the formation of a totally regenerated vascular structure. The surgical correction of the diseased heart would follow the natural course of patient's growth, with significant long-term benefits [4].