Current Challenges and Emergent Technologies for Manufacturing Artificial Right Ventricle to Pulmonary Artery (RV-PA) Cardiac Conduits

Manavitehrani, Iman; Ebrahimi, Pegah; Yang, Irene; Daly, S.; Saxena, Akshat; Little, David; Fletcher, David F.; Dehghani, Fariba; Winlaw, David S.

doi:10.1007/s13239-019-00406-5

Cited by 14 publications

(8 citation statements)

References 86 publications

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“…But 3D printing geometrically complex structures with similar biological behavior to natural tissues remains a great challenge, and ideal scaffold materials and conduit fabrication methods remain an area for continued effort and innovation. Current research advances in tissue engineering scaffolds are mostly limited to preclinical trials ( 144 ).…”

Section: Prospectmentioning

confidence: 99%

Application of Homograft Valved Conduit in Cardiac Surgery

Huyan

Chang

Song

2021

Front. Cardiovasc. Med.

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Valved conduits often correct the blood flow of congenital heart disease by connecting the right ventricle to the pulmonary artery (RV-PA). The homograft valved conduit was invented in the 1960s, but its wide application is limited due to the lack of effective sterilization and preservation methods. Modern cryopreservation prolongs the preservation time of homograft valved conduit, which makes it become the most important treatment at present, and is widely used in Ross and other operations. However, homograft valved conduit has limited biocompatibility and durability and lacks any additional growth capacity. Therefore, decellularized valved conduit has been proposed as an effective improved method, which can reduce immune response and calcification, and has potential growth ability. In addition, as a possible substitute, commercial xenograft valved conduit has certain advantages in clinical application, and tissue engineering artificial valved conduit needs to be further studied.

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Section: Prospectmentioning

confidence: 99%

Application of Homograft Valved Conduit in Cardiac Surgery

Huyan

Chang

Song

2021

Front. Cardiovasc. Med.

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“…A number of new bioabsorbable materials are in development for RVOT reconstruction in a variety of 3-dimensionalÀprinted and scaffold constructs. 33 A replaced valve that can grow with a patient could be a market game changer, although these technologies are currently remote from clinical application.…”

Section: Challenges and Future Directionsmentioning

confidence: 99%

Seven decades of valved right ventricular outflow tract reconstruction: The most common heart procedure in children

Herrmann

Brown

2020

The Journal of Thoracic and Cardiovascular Surgery

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“…In more than half of the patients requiring pulmonary valve implantations and in all such neonates, infants, and children up to the age of 5–6 years, the RVOT is entirely absent or insufficiently sized. [ 36 ] Thus, a valved conduit is the major clinical need for this population, as a valve‐only device would not be adequate to fully reconstruct the RVOT and properly accommodate growth. An expandable valve‐only prosthesis could potentially be inserted into an expandable vascular graft.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Proof of Concept of a First‐Generation Growth‐Accommodating Heart Valved Conduit for Pediatric Use

Sun

Russ

et al. 2023

Macromolecular Bioscience

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Currently available heart valve prostheses have no growth potential, requiring children with heart valve diseases to endure multiple valve replacement surgeries with compounding risks. This study demonstrates the in vitro proof of concept of a biostable polymeric trileaflet valved conduit designed for surgical implantation and subsequent expansion via transcatheter balloon dilation to accommodate the growth of pediatric patients and delay or avoid repeated open‐heart surgeries. The valved conduit is formed via dip molding using a polydimethylsiloxane‐based polyurethane, a biocompatible material shown here to be capable of permanent stretching under mechanical loading. The valve leaflets are designed with an increased coaptation area to preserve valve competence at expanded diameters. Four 22 mm diameter valved conduits are tested in vitro for hydrodynamics, balloon dilated to new permanent diameters of 23.26 ± 0.38 mm, and then tested again. Upon further dilation, two valved conduits sustain leaflet tears, while the two surviving devices reach final diameters of 24.38 ± 0.19 mm. After each successful dilation, the valved conduits show increased effective orifice areas and decreased transvalvular pressure differentials while maintaining low regurgitation. These results demonstrate concept feasibility and motivate further development of a polymeric balloon‐expandable device to replace valves in children and avoid reoperations.

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Current Challenges and Emergent Technologies for Manufacturing Artificial Right Ventricle to Pulmonary Artery (RV-PA) Cardiac Conduits

Cited by 14 publications

References 86 publications

Application of Homograft Valved Conduit in Cardiac Surgery

Application of Homograft Valved Conduit in Cardiac Surgery

Seven decades of valved right ventricular outflow tract reconstruction: The most common heart procedure in children

In Vitro Proof of Concept of a First‐Generation Growth‐Accommodating Heart Valved Conduit for Pediatric Use

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