3D-printed poly(p-dioxanone)/graphene oxide composite bioresorbable stents for congenital heart disease treatment

Bioresorbable stents (BRSs) offer significant advantages in treating congenital heart disease-related vascular stenoses, especially for pediatric patients. However, the insufficient mechanical performance of polymeric BRSs remains a critical challenge. In this study, Poly(p-dioxanone) (PPDO) was incorporated with graphene oxide (GO) for the first time to improve both mechanical properties and biocompatibility. PPDO/GO composites with varying GO contents were fabricated via solution mixing and solvent casting, and tensile tests revealed that lower GO content levels (0.2% and 0.5%) significantly improved the Young’s modulus, tensile strength, and elongation at break of PPDO due to hydrogen bonding and increased degree of crystallinity. 3D-printed PPDO/GO sliding-lock stents with optimal GO contents were fabricated by fused deposition modeling and demonstrated superior compression force compared to pristine PPDO stents. In vitro hemocompatibility and cytocompatibility assessments showed that 3D-printed PPDO/GO stents exhibited low hemolysis rate, reduced platelet adhesion, and enhanced adhesion and proliferation of endothelial cells. In vivo evaluation further demonstrated improved endothelialization in rat abdominal aortas implanted with 3D-printed PPDO/GO filaments for 4 weeks. Overall, PPDO/0.5%GO exhibited superior performance in compression force, hemocompatibility, cytocompatibility, and in vivo endothelialization. This study, for the first time, combines PPDO with GO and explains the mechanism of the enhanced mechanical properties of PPDO/GO composite material. Using 3D printing, PPDO/GO BRS with improved compression performance and biocompatibility were developed, highlighting its potential value for treating pediatric patients with CHD-related vascular stenoses.