A new approach to heart valve tissue engineering

"In vivo tissue-engineered" valved conduit with designed molds and laser processed scaffold

BACKGROUND

"In body tissue architecture" technology is a practical concept of regenerative medicine that uses the living recipient body's reaction to a foreign object as a reactor for autologous tissue organization. A novel autologous valved conduit was produced by creating a specially designed conduit-mold composite and elastomeric scaffold for this unique in vivo tissue engineering.

METHODS

Convex and concave plastic molds assembled with a small aperture of 500-800 microm were inserted into a microporous elastomeric conduit scaffold. The assembly was placed in a subcutaneous pocket of Japanese white rabbits for 1 month. The molds were pulled out from the edge of the harvested implant to obtain the valved conduit.

RESULTS

Homogenous and well-balanced trileaflet of membranous tissue was developed in the optimized aperture of molds. The valve leaflet closed and opened rapidly in synchronization with the backward and forward flow of the pulsatile flow circuit in vitro.

CONCLUSIONS

A tissue-engineered conduit incorporated with a functional autologous trileaflet valve was developed in an in vivo reactor by optimizing the microstructures of conduit scaffolds and newly designing the composite molds. The method holds promise for a safe, biocompatible, and economical heart valve prosthesis.

Development of an in vivo tissue-engineered, autologous heart valve (the biovalve): preparation of a prototype model

OBJECTIVE

This study aimed to develop an autologous heart valve without using traditional in vitro tissue-engineering methods, which necessitate complicated cell management protocols under exceptionally clean laboratory facilities.

METHODS

An autologous heart valve construct composed of trileaflets was prepared using a specially designed mold. The mold was prepared by covering a silicone rod with a crown-shaped tubular polyurethane scaffold containing 3 horns. The mold was implanted in the dorsal subcutaneous space in Japan White rabbits for 4 weeks. After harvesting, the implanted trileaflet valve-shaped structure with an internal diameter of either 5 or 20 mm was obtained by trimming the membranous tissue formed between the horns located around the silicone rod. The valve substitute was examined both macroscopically and histologically. The tensile strength of the leaflets was measured to rupture. The degree of regurgitation in valve function was evaluated using a flow circuit by calculating the ratio of the regurgitation volume to the forward flow volume.

RESULTS

After implantation, the mold was completely covered with connective tissue consisting mostly of collagen and fibroblasts. Harvesting of the mold was straightforward, because there was little adhesion between the formed tissue and the native skin tissue. The trileaflet heart valve construct was obtained after withdrawing the inserted rods and trimming the membranous tissues formed between the horns of the scaffold. It was firmly attached to the scaffold, the interstices and surface of which revealed connective tissues composed of components similar to those of the leaflet tissue. Although the mechanical properties of the leaflet tissue were less efficient than those of the native porcine aortic valve leaflets, satisfactory valvular functions were demonstrated under pulsatile conditions using a flow circuit. No regurgitation was observed under retrograde hydrostatic pressures of up to 60 mm Hg, the physiologic pressure acting on the aortic valves during retrograde aortic flow.

CONCLUSIONS

The biovalve, an autologous, in vivo tissue-engineered, trileaflet, valve-shaped construct, was developed using our novel in-body tissue architecture technology. The biovalve has the potential to be an ideal prosthetic heart valve, with excellent biocompatibility to the growth of the recipient's heart.