The long term objective of this proposal is to develop a synthetic pericardium for use following open heart surgical procedures and in the use of a total artificial heart bridge to transplantation. The approach utilizes a new class of biomaterials, elastomeric polypeptides, that can be cross-linked to form biocompatible, elastomeric matrices. The methodologies involve peptide synthesis, fabrication of elastomeric matrices, incorporation of cell attachment sites and cytokines, cell culture testing for mesothelial cell adhesion, cell growth and matrix remodeling, and in vivo testing to evaluate efficacy and follow remodelling of the synthetic functional pericardium into a natural pericardium. In Phase I, focus will be on the use of the simplest matrix as a biocompatible elastomeric barrier (to which cells do not adhere and around which fibrous encapsulation does not occur) to prevent the formation of deleterious postoperative adhesions.The simplest matrix is to be tested in the calf under cardiopulmonary bypass to prevent adhesion to the lung, and in the artificial heart to wrap the Dacron vascular graft used to conduct the blood from the both the pulmonary artery and the aorta to the remnant and pulmonary artery and to cover the Dacron velour covering placed on the exterior for the artificial atrial cuffs that adhere to the pericardial wall on the left atrium and the lung on the right atrium. In 1989 more the 400,000 open-heart surgical procedures were performed in the U.S.A.; in some centers up to one in five of the surgical cases were 'redo' patients. The scarring adhesions result in constrictive pericarditis; and, in 'redo' operations, in severe hemorrhage or the severing previously implanted coronary artery vascular grafts.
