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Türkoğlu GC, Khomarloo N, Mohsenzadeh E, Gospodinova DN, Neznakomova M, Salaün F. PVA-Based Electrospun Materials-A Promising Route to Designing Nanofiber Mats with Desired Morphological Shape-A Review. Int J Mol Sci 2024; 25:1668. [PMID: 38338946 PMCID: PMC10855838 DOI: 10.3390/ijms25031668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Poly(vinyl alcohol) is one of the most attractive polymers with a wide range of uses because of its water solubility, biocompatibility, low toxicity, good mechanical properties, and relatively low cost. This review article focuses on recent advances in poly(vinyl alcohol) electrospinning and summarizes parameters of the process (voltage, distance, flow rate, and collector), solution (molecular weight and concentration), and ambient (humidity and temperature) in order to comprehend the influence on the structural, mechanical, and chemical properties of poly(vinyl alcohol)-based electrospun matrices. The importance of poly(vinyl alcohol) electrospinning in biomedical applications is emphasized by exploring a literature review on biomedical applications including wound dressings, drug delivery, tissue engineering, and biosensors. The study also highlights a new promising area of particles formation through the electrospraying of poly(vinyl alcohol). The limitations and advantages of working with different poly(vinyl alcohol) matrices are reviewed, and some recommendations for the future are made to advance this field of study.
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Affiliation(s)
- Gizem Ceylan Türkoğlu
- Department of Textile Engineering, Dokuz Eylul University, İzmir 35397, Turkey;
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, F-59000 Lille, France; (N.K.); (E.M.)
| | - Niloufar Khomarloo
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, F-59000 Lille, France; (N.K.); (E.M.)
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, Junia, F-59000 Lille, France
| | - Elham Mohsenzadeh
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, F-59000 Lille, France; (N.K.); (E.M.)
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, Junia, F-59000 Lille, France
| | - Dilyana Nikolaeva Gospodinova
- Faculty of Electrical Engineering, Department of Electrical Apparatus, Technical University of Sofia, 1156 Sofia, Bulgaria;
| | - Margarita Neznakomova
- Faculty of Industrial Technology, Department of Material Science and Technology of Materials, Technical University of Sofia, 1000 Sofia, Bulgaria;
| | - Fabien Salaün
- Univ. Lille, ENSAIT, ULR 2461-GEMTEX-Génie et Matériaux Textiles, F-59000 Lille, France; (N.K.); (E.M.)
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2
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Konsek H, Sherard C, Bisbee C, Kang L, Turek JW, Rajab TK. Growing Heart Valve Implants for Children. J Cardiovasc Dev Dis 2023; 10:jcdd10040148. [PMID: 37103027 PMCID: PMC10143004 DOI: 10.3390/jcdd10040148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
The current standard of care for pediatric patients with unrepairable congenital valvular disease is a heart valve implant. However, current heart valve implants are unable to accommodate the somatic growth of the recipient, preventing long-term clinical success in these patients. Therefore, there is an urgent need for a growing heart valve implant for children. This article reviews recent studies investigating tissue-engineered heart valves and partial heart transplantation as potential growing heart valve implants in large animal and clinical translational research. In vitro and in situ designs of tissue engineered heart valves are discussed, as well as the barriers to clinical translation.
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3
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Ingeniería de tejidos en población pediátrica: una esperanza para el tratamiento de enfermedades valvulares mitrales congénitas. CIRUGIA CARDIOVASCULAR 2023. [DOI: 10.1016/j.circv.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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4
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Wang B, Sierad LN, Mercuri JJ, Simionescu A, Simionescu DT, Williams LN, Vela R, Bajona P, Peltz M, Ramaswamy S, Hong Y, Liao J. Structural and biomechanical characterizations of acellular porcine mitral valve scaffolds: anterior leaflets, posterior leaflets, and chordae tendineae. ENGINEERED REGENERATION 2022; 3:374-386. [PMID: 38362305 PMCID: PMC10869114 DOI: 10.1016/j.engreg.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mitral valve (MV) tissue engineering is still in its early stage, and one major challenge in MV tissue engineering is to identify appropriate scaffold materials. With the potential of acellular MV scaffolds being demonstrated recently, it is important to have a full understanding of the biomechanics of the native MV components and their acellular scaffolds. In this study, we have successfully characterized the structural and mechanical properties of porcine MV components, including anterior leaflet (AL), posterior leaflet (PL), strut chordae, and basal chordae, before and after decellularization. Quantitative DNA assay showed more than 90% reduction in DNA content, and Griffonia simplicifolia (GS) lectin immunohistochemistry confirmed the complete lack of porcine α-Gal antigen in the acellular MV components. In the acellular AL and PL, the atrialis, spongiosa, and fibrosa trilayered structure, along with its ECM constitutes, i.e., collagen fibers, elastin fibers, and portion of GAGs, were preserved. Nevertheless, the ECM of both AL and PL experienced a certain degree of disruption, exhibiting a less dense, porous ECM morphology. The overall anatomical morphology of the strut and basal chordae were also maintained after decellularization, with longitudinal morphology experiencing minimum disruption, but the cross-sectional morphology exhibiting evenly-distributed porous structure. In the acellular AL and PL, the nonlinear anisotropic biaxial mechanical behavior was overall preserved; however, uniaxial tensile tests showed that the removal of cellular content and the disruption of structural ECM did result in small decreases in maximum tensile modulus, tissue extensibility, failure stress, and failure strain for both MV leaflets and chordae.
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Affiliation(s)
- Bo Wang
- Joint Department of Biomedical Engineering, Medical College of Wisconsin and Marquette University, Milwaukee, WI 53226, United States
| | - Leslie N. Sierad
- Department of Bioengineering, Clemson University, Clemson, SC 29634, United States
| | - Jeremy J. Mercuri
- Department of Bioengineering, Clemson University, Clemson, SC 29634, United States
| | - Agneta Simionescu
- Department of Bioengineering, Clemson University, Clemson, SC 29634, United States
| | - Dan T. Simionescu
- Department of Bioengineering, Clemson University, Clemson, SC 29634, United States
| | - Lakiesha N. Williams
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, United States
| | - Ryan Vela
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Pietro Bajona
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
- Allegheny Health Network-Drexel University College of Medicine, Pittsburgh, PA 15212, United States
| | - Matthias Peltz
- Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Sharan Ramaswamy
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, United States
| | - Yi Hong
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX 76010, United States
| | - Jun Liao
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX 76010, United States
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5
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Rizzi S, Ragazzini S, Pesce M. Engineering Efforts to Refine Compatibility and Duration of Aortic Valve Replacements: An Overview of Previous Expectations and New Promises. Front Cardiovasc Med 2022; 9:863136. [PMID: 35509271 PMCID: PMC9058060 DOI: 10.3389/fcvm.2022.863136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/28/2022] [Indexed: 01/18/2023] Open
Abstract
The absence of pharmacological treatments to reduce or retard the progression of cardiac valve diseases makes replacement with artificial prostheses (mechanical or bio-prosthetic) essential. Given the increasing incidence of cardiac valve pathologies, there is always a more stringent need for valve replacements that offer enhanced performance and durability. Unfortunately, surgical valve replacement with mechanical or biological substitutes still leads to disadvantages over time. In fact, mechanical valves require a lifetime anticoagulation therapy that leads to a rise in thromboembolic complications, while biological valves are still manufactured with non-living tissue, consisting of aldehyde-treated xenograft material (e.g., bovine pericardium) whose integration into the host fails in the mid- to long-term due to unresolved issues regarding immune-compatibility. While various solutions to these shortcomings are currently under scrutiny, the possibility to implant fully biologically compatible valve replacements remains elusive, at least for large-scale deployment. In this regard, the failure in translation of most of the designed tissue engineered heart valves (TEHVs) to a viable clinical solution has played a major role. In this review, we present a comprehensive overview of the TEHVs developed until now, and critically analyze their strengths and limitations emerging from basic research and clinical trials. Starting from these aspects, we will also discuss strategies currently under investigation to produce valve replacements endowed with a true ability to self-repair, remodel and regenerate. We will discuss these new developments not only considering the scientific/technical framework inherent to the design of novel valve prostheses, but also economical and regulatory aspects, which may be crucial for the success of these novel designs.
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Affiliation(s)
- Stefano Rizzi
- Tissue Engineering Unit, Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico (IRCCS), Milan, Italy
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
- Stefano Rizzi
| | - Sara Ragazzini
- Tissue Engineering Unit, Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico (IRCCS), Milan, Italy
| | - Maurizio Pesce
- Tissue Engineering Unit, Centro Cardiologico Monzino, Istituto di ricovero e cura a carattere scientifico (IRCCS), Milan, Italy
- *Correspondence: Maurizio Pesce
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6
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Wang Y, Wu H, Zhou Z, Maitz MF, Liu K, Zhang B, Yang L, Luo R, Wang Y. A thrombin-triggered self-regulating anticoagulant strategy combined with anti-inflammatory capacity for blood-contacting implants. SCIENCE ADVANCES 2022; 8:eabm3378. [PMID: 35245113 PMCID: PMC8896797 DOI: 10.1126/sciadv.abm3378] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/13/2022] [Indexed: 05/17/2023]
Abstract
Interrelated coagulation and inflammation are impediments to endothelialization, a prerequisite for the long-term function of cardiovascular materials. Here, we proposed a self-regulating anticoagulant coating strategy combined with anti-inflammatory capacity, which consisted of thrombin-responsive nanogels with anticoagulant and anti-inflammatory components. As an anticoagulant, rivaroxaban was encapsulated in nanogels cross-linked by thrombin-cleavable peptide and released upon the trigger of environmental thrombin, blocking the further coagulation cascade. The superoxide dismutase mimetic Tempol imparted the antioxidant property. Polyphenol epigallocatechin gallate (EGCG), in addition to its anti-inflammatory function in synergy with Tempol, also acted as a weak cross-linker to stabilize the coating. The effectiveness and versatility of this coating were validated using two typical cardiovascular devices as models, biological valves and vascular stents. It was demonstrated that the coating worked as a precise strategy to resist coagulation and inflammation, escorted reendothelialization on the cardiovascular devices, and provided a new perspective for designing endothelium-like functional coatings.
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Affiliation(s)
- Yanan Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Haoshuang Wu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Zhongyi Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Manfred F. Maitz
- Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials Dresden, Dresden 01069, Germany
- Key Laboratory for Advanced Technologies of Materials, Ministry of Education, School of Material Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China
| | - Kunpeng Liu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Bo Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Li Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Rifang Luo
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- Corresponding author. (R.L.); (Yunbing Wang)
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- Corresponding author. (R.L.); (Yunbing Wang)
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7
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A multi-in-one strategy with glucose-triggered long-term antithrombogenicity and sequentially enhanced endothelialization for biological valve leaflets. Biomaterials 2021; 275:120981. [PMID: 34171754 DOI: 10.1016/j.biomaterials.2021.120981] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/03/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
Bioprosthetic heart valves are commonly applied in heart valve replacement, while the effectiveness is limited by inflammation, calcification and especially thrombosis. Surface modification is expected to endow the biological valves with versatility. Herein, a multi-in-one strategy was established to modify biological valves with long-term antithrombogenicity and sequentially enhanced endothelialization triggered by glucose, in which the direct thrombin inhibitor rivaroxaban (RIVA)-loaded nanogels were embedded and the detachable polyethylene glycol (PEG) was grafted. These two anticoagulant strategies were connected by glucose oxidase (GOx), which catalyzed the oxidation of glucose to produce hydrogen peroxide (H2O2) and local acidic environment. The generated H2O2 stimulated H2O2-responsive nanogels release RIVA to obtain continuous antithrombogenicity. Meanwhile, PEG was attached to the surface via pH-sensitive bonds, which prevented thrombus formation by resisting the serum proteins and platelets adhesion at the initial stage of material/blood contact. Sequentially, PEG gradually peeled off under the local weak acidic environment, which ultimately resulted in the endothelialization enhancement. Within such multi-in-one strategy, the biological valve leaflets induced long-term anticoagulant performance, gradually enhanced endothelialization and improved tissue affinity, including anti-calcification and anti-inflammation, indicating the potential of the response sequence matching between materials and tissues after implantation, which might improve performance of biological heart valves.
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8
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Ravishankar P, Ozkizilcik A, Husain A, Balachandran K. Anisotropic Fiber-Reinforced Glycosaminoglycan Hydrogels for Heart Valve Tissue Engineering. Tissue Eng Part A 2020; 27:513-525. [PMID: 32723024 DOI: 10.1089/ten.tea.2020.0118] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This study investigates polymer fiber-reinforced protein-polysaccharide-based hydrogels for heart valve tissue engineering applications. Polycaprolactone and gelatin (3:1) blends were jet-spun to fabricate aligned fibers that possessed fiber diameters in the range found in the native heart valve. These fibers were embedded in methacrylated hydrogels made from gelatin, sodium hyaluronate, and chondroitin sulfate to create fiber-reinforced hydrogel composites (HCs). The fiber-reinforced gelatin glycosaminoglycan (GAG)-based HC possessed interconnected porous structures and porosity higher than fiber-only conditions. These fiber-reinforced HCs exhibited compressive modulus and biaxial mechanical behavior comparable to that of native porcine aortic valves. The fiber-reinforced HCs were able to swell higher and degraded less than the hydrogels. Elution studies revealed that less than 20% of incorporated gelatin methacrylate and GAGs were released over 2 weeks, with a steady-state release after the first day. When cultured with porcine valve interstitial cells (VICs), the fiber-reinforced composites were able to maintain higher cell viability compared with fiber-only samples. Quiescent VICs expressed alpha smooth muscle actin and calponin showing an activated phenotype, along with a few cells expressing the proliferation marker Ki67 and negative expression for RUNX2, an osteogenic marker. Our study demonstrated that compared with the hydrogels and fibers alone, combining both components can yield durable, reinforced composites that mimic heart valve mechanical behavior, while maintaining high cell viability and expressing positive activation as well as proliferation markers.
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Affiliation(s)
- Prashanth Ravishankar
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Asya Ozkizilcik
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Anushae Husain
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Kartik Balachandran
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
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9
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Personalized Interventions: A Reality in the Next 20 Years or Pie in the Sky. Pediatr Cardiol 2020; 41:486-502. [PMID: 32198592 DOI: 10.1007/s00246-020-02303-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/17/2020] [Indexed: 12/22/2022]
Abstract
There is no better representation of the need for personalization of care than the breadth and complexity of congenital heart disease. Advanced imaging modalities are now standard of care in the field, and the advancements being made to three-dimensional visualization technologies are growing as a means of pre-procedural preparation. Incorporating emerging modeling approaches, such as computational fluid dynamics, will push the limits of our ability to predict outcomes, and this information may be both obtained and utilized during a single procedure in the future. Artificial intelligence and customized devices may soon surface as realistic tools for the care of patients with congenital heart disease, as they are showing growing evidence of feasibility within other fields. This review illustrates the great strides that have been made and the persistent challenges that exist within the field of congenital interventional cardiology, a field which must continue to innovate and push the limits to achieve personalization of the interventions it provides.
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10
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Acute In Vivo Functional Assessment of a Biodegradable Stentless Elastomeric Tricuspid Valve. J Cardiovasc Transl Res 2020; 13:796-805. [DOI: 10.1007/s12265-020-09960-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
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Wollmann LC, Suss PH, Kraft L, Ribeiro VS, Noronha L, da Costa FDA, Tuon FF. Histological and Biomechanical Characteristics of Human Decellularized Allograft Heart Valves After Eighteen Months of Storage in Saline Solution. Biopreserv Biobank 2020; 18:90-101. [PMID: 31990593 DOI: 10.1089/bio.2019.0106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: The best storage preservation method for maintaining the quality and safety of human decellularized allograft heart valves is yet to be established. Objective: The aim of the present study was to evaluate the stability in terms of extracellular matrix (ECM) integrity of human heart valve allografts decellularized using sodium dodecyl sulfate-ethylenediaminetetraacetic acid (SDS-EDTA) and stored for 6, 12, and 18 months. Methods: A total of 70 decellularized aortic and pulmonary valves were analyzed across different storage times (0, 6, 12, and 18 months) for solution pH measurements, histological findings, cytotoxicity assay results, biomechanical test results, and microbiological suitability test results. Continuous data were analyzed using one-way analysis of variance comparing the follow-up times. Results: The pH of the stock solution did not change during the different time points, and no microbial growth occurred up to 18 months. Histological analysis showed that the decellularized allografts did not present deleterious outcomes or signs of structural degeneration in the ECM up to 12 months. The biomechanical properties showed changes over time in different aspects. Allografts stored for 18 months presented lower tensile strength and elasticity than those stored for 12 months (p < 0.05). The microbiological suitability test suggested no residual antimicrobial effects. Conclusion: Changes in the structure and functionality of SDS-EDTA decellularized heart valve allografts occur after 12 months of storage.
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Affiliation(s)
- Luciana Cristina Wollmann
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Paula Hansen Suss
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Leticia Kraft
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Lúcia Noronha
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Experimental Pathology Laboratory, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Francisco Diniz Affonso da Costa
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Felipe Francisco Tuon
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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12
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Zhang BL, Bianco RW, Schoen FJ. Preclinical Assessment of Cardiac Valve Substitutes: Current Status and Considerations for Engineered Tissue Heart Valves. Front Cardiovasc Med 2019; 6:72. [PMID: 31231661 PMCID: PMC6566127 DOI: 10.3389/fcvm.2019.00072] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022] Open
Abstract
Tissue engineered heart valve (TEHV) technology may overcome deficiencies of existing available heart valve substitutes. The pathway by which TEHVs will undergo development and regulatory approval has several challenges. In this communication, we review: (1) the regulatory framework for regulation of medical devices in general and substitute heart valves in particular; (2) the special challenges of preclinical testing using animal models for TEHV, emphasizing the International Standards Organization (ISO) guidelines in document 5840; and (3) considerations that suggest a translational roadmap to move TEHV forward from pre-clinical to clinical studies and clinical implementation.
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Affiliation(s)
- Benjamin L Zhang
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Richard W Bianco
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Frederick J Schoen
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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13
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Coyan GN, D'Amore A, Matsumura Y, Pedersen DD, Luketich SK, Shanov V, Katz WE, David TE, Wagner WR, Badhwar V. In vivo functional assessment of a novel degradable metal and elastomeric scaffold-based tissue engineered heart valve. J Thorac Cardiovasc Surg 2018; 157:1809-1816. [PMID: 30578064 DOI: 10.1016/j.jtcvs.2018.09.128] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 09/01/2018] [Accepted: 09/22/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Ideal heart valve solutions aim to provide thrombosis-free durability. A scaffold-based polycarbonate urethane urea tissue-engineered heart valve designed to mimic native valve microstructure and function was used. This study examined the acute in vivo function of a stented tissue-engineered heart valve in a porcine model. METHODS Trileaflet valves were fabricated by electrospinning polycarbonate urethane urea using double component fiber deposition. The tissue-engineered heart valve was mounted on an AZ31 magnesium alloy biodegradable stent frame. Five 80-kg Yorkshire pigs underwent open tissue-engineered heart valve implantation on cardiopulmonary bypass in the pulmonary position. Tissue-engineered heart valve function was echocardiographically evaluated immediately postimplant and at planned study end points at 1, 4, 8, and 12 hours. Explanted valves underwent biaxial mechanical testing and scanning electron microscopy for ultrastructural analysis and thrombosis detection. RESULTS All 5 animals underwent successful valve implantation. All were weaned from cardiopulmonary bypass, closed, and recovered until harvest study end point except 1 animal that was found to have congenital tricuspid valve dysplasia and that was euthanized postimplant. All 5 cases revealed postcardiopulmonary bypass normal leaflet function, no regurgitation, and an average peak velocity of 2 m/s, unchanged at end point. All tissue-engineered heart valve leaflets retained microstructural architecture with no platelet activation or thrombosis by scanning electron microscopy. There was microscopic evidence of fibrin deposition on 2 of 5 stent frames, not on the tissue-engineered heart valve. Biaxial stress examination revealed retained postimplant mechanics of tissue-engineered heart valve fibers without functional or ultrastructural degradation. CONCLUSIONS A biodegradable elastomeric heart valve scaffold for in situ tissue-engineered leaflet replacement is acutely functional and devoid of leaflet microthrombosis.
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Affiliation(s)
- Garrett N Coyan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Antonio D'Amore
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa; Fondazione RiMED, Palermo, Italy
| | - Yasumoto Matsumura
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Drake D Pedersen
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Samuel K Luketich
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Vesselin Shanov
- Department of Bioengineering, University of Cincinnati, Cincinnati, Ohio
| | - William E Katz
- Division of Cardiology, University of Pittsburgh, Pittsburgh, Pa
| | - Tirone E David
- Division of Cardiac Surgery, Toronto General Hospital, Toronto, Ontario, Canada
| | - William R Wagner
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Vinay Badhwar
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pa; Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
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14
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Jover E, Fagnano M, Angelini G, Madeddu P. Cell Sources for Tissue Engineering Strategies to Treat Calcific Valve Disease. Front Cardiovasc Med 2018; 5:155. [PMID: 30460245 PMCID: PMC6232262 DOI: 10.3389/fcvm.2018.00155] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular calcification is an independent risk factor and an established predictor of adverse cardiovascular events. Despite concomitant factors leading to atherosclerosis and heart valve disease (VHD), the latter has been identified as an independent pathological entity. Calcific aortic valve stenosis is the most common form of VDH resulting of either congenital malformations or senile “degeneration.” About 2% of the population over 65 years is affected by aortic valve stenosis which represents a major cause of morbidity and mortality in the elderly. A multifactorial, complex and active heterotopic bone-like formation process, including extracellular matrix remodeling, osteogenesis and angiogenesis, drives heart valve “degeneration” and calcification, finally causing left ventricle outflow obstruction. Surgical heart valve replacement is the current therapeutic option for those patients diagnosed with severe VHD representing more than 20% of all cardiac surgeries nowadays. Tissue Engineering of Heart Valves (TEHV) is emerging as a valuable alternative for definitive treatment of VHD and promises to overcome either the chronic oral anticoagulation or the time-dependent deterioration and reintervention of current mechanical or biological prosthesis, respectively. Among the plethora of approaches and stablished techniques for TEHV, utilization of different cell sources may confer of additional properties, desirable and not, which need to be considered before moving from the bench to the bedside. This review aims to provide a critical appraisal of current knowledge about calcific VHD and to discuss the pros and cons of the main cell sources tested in studies addressing in vitro TEHV.
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Affiliation(s)
- Eva Jover
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Marco Fagnano
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Gianni Angelini
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Paolo Madeddu
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
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Namdari M, Negahdari B, Eatemadi A. Paediatric nanofibrous bioprosthetic heart valve. IET Nanobiotechnol 2017; 11:493-500. [PMID: 28745279 PMCID: PMC8676244 DOI: 10.1049/iet-nbt.2016.0159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/28/2016] [Accepted: 11/30/2016] [Indexed: 09/22/2023] Open
Abstract
The search for an optimal aortic valve implant with durability, calcification resistance, excellent haemodynamic parameters and ability to withstand mechanical loading is yet to be met. Thus, there has been struggled to fabricate bio-prosthetics heart valve using bioengineering. The consequential product must be resilient with suitable mechanical features, biocompatible and possess the capacity to grow. Defective heart valves replacement by surgery is now common, this improves the value and survival of life for a lot of patients. The recent paediatric heart valve implant is suboptimal due to their inability of somatic growth. They usually have multiple surgeries to change outgrown valves. Short-lived valve bio-prostheses occurring in older patients and younger ones who more usually need the replacement of its damaged heart with prosthesis led to a new invasive surgical interventions with an improved quality of life. The authors propose that nanofibre scaffold for paediatric tissue-engineered heart valve will meet most of these conditions, most particularly those related to somatic growth, and, as the nanofibre scaffold is eroded, new valve is produced, the valve matures in the child until adulthood.
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Affiliation(s)
- Mehrdad Namdari
- Department of Cardiology, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Babak Negahdari
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Eatemadi
- Department of Medical Biotechnology, School of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran.
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