Abstract

Noncardiac operations are being increasingly performed on patients with left ventricular assist devices (LVADs). However, little is known on the impact of continuous-flow LVADs on the vascular supply of the colon for anastomoses. In this case, a 67-year-old male supported on an LVAD underwent four successful noncardiac operations including two intestinal anastomoses, left colon and small bowel anastomosis. To the best of our knowledge, no existing literature has reported successful colonic anastomosis on a continuous-flow LVAD. This case illustrates the plausibility of performing colonic anastomoses with appropriately selected patients supported on an LVAD. A 67-year-old male with congestive heart failure underwent LVAD placement for decompensated heart failure while awaiting orthotopic transplantation. During his recovery, he developed a stage IV sacral decubitus ulcer which required a sigmoid loop colostomy placement and a rotational flap. Subsequent stoma closure with partial sigmoid colectomy and stapled anastomosis was performed, and healed without evidence of anastomotic leak. This case illustrates the potential for colonic anastomoses for patients on continuous-flow LVAD support. Although oxygenation is known to be an important aspect of healing, this patients outcome suggests that intestinal anastomoses can be performed on the induced pulseless environment of an LVAD. Further studies will be needed to further elucidate the success of longer segment resections and appropriate surgical candidates.

Abstract

Over the last decade, much interest has been developed in biopolymer based materials due to their biocompatible, biodegradable, non-toxic and non-allergenic nature. Chitosan is a unique biopolymer that exhibits outstanding properties, besides biocompatibility and biodegradability. Most of these peculiar properties arise from the presence of primary amines along the chitosan backbone. Many works have been done to obtain chitosan based scaffolds, including surface modifications, the fabrication of chitosan based blends, chitosan based composite scaffolds, and drug-loaded scaffolds. This study provides an overview of the key features of inherent properties of chitosan, their modification, and its use in biomedical engineering particularly toward anti-inflammatory and wound healing.