Heart diseases requiring surgical intervention are becoming increasingly common, with nearly a billion people worldwide already suffering from them. These delicate procedures almost always require some sort of structural reinforcements, whether to completely replace a vascular section or to repair damage caused by disease and the surgery itself.
The most common method for these procedures involves taking healthy vascular tissue from elsewhere in the patient’s body and grafting it into areas of need. But as diabetes and other increasingly common conditions make people’s veins too frail to use in this manner, the use of synthetic grafts is increasing.
While less than 3% of procedures using synthetic grafts lead to infections, it is a major problem when it happens. Mortality rates are as high as 40% over four years, and researchers don’t know why such infections occur.
Now, research from Duke University points to a potential culprit: uniform materials without any diversity or complexity, such as emerging hydrogels—or the scar tissue that forms around suture sites. The results point toward the potential use of “decellularized” bioengineered grafts to greatly reduce the rate of these complications.
The results appeared online February 17 in the Journal of Biomedical Materials Part A .
“Grafts using a patient’s own vascular tissues don’t have this infection problem, and our results show that other types of lab-grown tissue are great at stopping bacterial penetration,” said A-Andrew Jones, assistant professor of civil and environmental engineering. “The only potential culprit left is that interface where the stitches are.”
The most common and long-used materials for these types of grafts are expanded polytetrafluoroethylene (ePTFE, also known as Teflon) and polyurethane. More recently, engineered hydrogels and lab-grown decellularized tissue with its living cells removed have been pursued as potential replacements.
Interestingly, previous work has shown that coating any of these various materials with a wide range of antimicrobial agents does not reduce the incidence of eventual infection. So how are bacteria getting into the graft sites and causing infections?
To find out, Jones and his lab introduced two strains of pathogenic bacteria to swatches of the up-and-coming bioengineered tissues. After six hours, the tests showed that some bacteria were able to penetrate and move across the two hydrogels. But while the bacteria grew into the decellularized tissue, they could not move all the way through it.
“Materials without any complexity appear to be what allows bacteria to penetrate through, and the scar tissue that forms between today’s synthetic grafts and the patient’s cardiovascular system is very similar to that,” Jones said. “Much more work needs to be done, but this suggests that we should be trying to design new solutions similar to vascular tissue in interior complexity.”
These initial tests, Jones said, are pretty straightforward and simple. Living tissue was not tested. Experiments were not run inside a living animal. The materials tested were not even in the same shape as a blood vessel. But that is all work that Jones said he is excited to pursue.
This work was supported by the National Institutes of Health (R35 GM142898).
“In vitro evaluation of Escherichia coli and Staphylococcus aureus translocation in 3D printed material.” Ashma Sharma, Joshua Prince, A-Andrew D Jones III. J Biomed Mater Res A , 2026. DOI: 10.1002/jbm.a.70050
Biomedical Materials
Experimental study
Not applicable
In vitro evaluation of Escherichia coli and Staphylococcus aureus translocation in 3D printed material
17-Feb-2026