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Discussion

        Dr John Edmund Mayer, Jr(Boston, Mass). You have some patients who have not survived long term in your tissue-engineered extracardiac Fontan group. Do you have any histologic studies on those explanted grafts from autopsy?
        Dr Hibino. Unfortunately, for these TCPC graft-implanted patients, the families declined autopsies; therefore, we do not have the histologic information. We have the histologic data, however, from reoperation patients. In these patients we used a tissue engineered graft as a patch for pulmonary angioplasty in a stenosed region. After the angioplasty, pulmonary artery stenosis developed again, including the portion replaced with the TEVG. Here is the histology of the explanted graft at reoperation. In this image we note endothelialization of the tissue and smooth muscle layer formation, which suggests neotissue formation.