Developing a Clinically Relevant Tissue Engineered Heart Valve—A Review of Current Approaches

Nachlas, Aline L.Y.; Li, Siyi; Davis, Michael

doi:10.1002/adhm.201700918

Cited by 31 publications

(18 citation statements)

References 302 publications

(384 reference statements)

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“…Unfortunately, "one valve for life" is not yet on the horizon. Research into tissue engineered valves has made great progress, however in vivo use in humans is not yet available (37,38). Meanwhile, other novel treatment strategies are available that are possibly underutilized.…”

Section: Novel Treatment Strategiesmentioning

confidence: 99%

Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old

Gökalp

Heer

Etnel

et al. 2019

Ann. Cardiothorac. Surg.

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Selecting the optimal surgical treatment strategy in patients below the age of 65 years (i.e., non-elderly patients) with aortic valve or aortic root disease remains challenging. The objective of the current study is to summarize contemporary research on clinical and quality of life outcomes after aortic valve replacement (AVR) and aortic root surgery in non-elderly patients. Recent systematic reviews on clinical outcome after biological and mechanical AVR, the Ross procedure and aortic root surgery show that event occurrence is considerable after any type of AVR or aortic root surgery and-with the exception of the Ross proceduresurvival is suboptimal. Although thromboembolism and bleeding events are more common after mechanical AVR and root surgery, these events are also considerably present after biological AVR, the Ross procedure and valve-sparing aortic root surgery (VSRR). Similarly, reoperation is more common after biological AVR, the Ross procedure and VSRR, but also occurs frequently after mechanical AVR and root replacement. Published evidence in AVR patients points to the direction of better health-related quality of life (HRQoL) outcomes with a biological solutions, while the HRQoL after aortic root surgery is limited and contradictory. This review illustrates that treatment for non-elderly aortic valve and aortic root disease patients needs to be tailored to the individual patient, considering both clinical and HRQoL outcomes as crucial factors to reach a treatment decision that best reflects the patient's values and goals in life.

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Section: Novel Treatment Strategiesmentioning

confidence: 99%

Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old

Gökalp

Heer

Etnel

et al. 2019

Ann. Cardiothorac. Surg.

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“…However, although synthetic and even some naturally-derived polymers do not exhibit intrinsic cell supporting capabilities, they can be readily modified through the incorporation of bioactive peptides such as RGD, CAG, REDV, and YIGSR [59,60]. The different types of naturally-derived and synthetic-based biomaterials used in the development of tissue engineered myocardium [61][62][63], cardiac valves [64][65][66][67], and blood vessels [68][69][70][71][72] have been extensively reviewed in the literature and will not be discussed here.…”

Section: Biomimetic Design Of Biomaterials For Cardiovascular Tementioning

confidence: 99%

Biomimetic cardiovascular platforms for in vitro disease modeling and therapeutic validation

et al. 2019

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Bioengineered tissues have become increasingly more sophisticated owing to recent advancements in the fields of biomaterials, microfabrication, microfluidics, genetic engineering, and stem cell and developmental biology. In the coming years, the ability to engineer artificial constructs that accurately mimic the compositional, architectural, and functional properties of human tissues, will profoundly impact the therapeutic and diagnostic aspects of the healthcare industry. In this regard, bioengineered cardiac tissues are of particular importance due to the extremely limited ability of the myocardium to self-regenerate, as well as the remarkably high mortality associated with cardiovascular diseases worldwide. As novel microphysiological systems make the transition from bench to bedside, their implementation in high throughput drug screening, personalized diagnostics, disease modeling, and targeted therapy validation will bring forth a paradigm shift in the clinical management of cardiovascular diseases. Here, we will review the current state of the art in experimental in vitro platforms for next generation diagnostics and therapy validation. We will describe recent advancements in the development of smart biomaterials, biofabrication techniques, and stem cell engineering, aimed at recapitulating cardiovascular function at the tissue- and organ levels. In addition, integrative and multidisciplinary approaches to engineer biomimetic cardiovascular constructs with unprecedented human and clinical relevance will be discussed. We will comment on the implementation of these platforms in high throughput drug screening, in vitro disease modeling and therapy validation. Lastly, future perspectives will be provided on how these biomimetic platforms will aid in the transition towards patient centered diagnostics, and the development of personalized targeted therapeutics.

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“…), has the aim of aiding cell survival, function, and proliferation whilst concomitantly minimising immune responses, which is especially important for tissues to be used in clinical applications, such as heart valves. These scaffolds have been widely reviewed elsewhere [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], including their use with bioreactor technology. Typically, they are porous to increase cell/scaffold area and promote 3-dimensional growth of the seeded cells.…”

Section: Bioreactor Designsmentioning

confidence: 99%

Role of Bioreactor Technology in Tissue Engineering for Clinical Use and Therapeutic Target Design

Selden

Fuller

2018

Bioengineering

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Micro and small bioreactors are well described for use in bioprocess development in pre-production manufacture, using ultra-scale down and microfluidic methodology. However, the use of bioreactors to understand normal and pathophysiology by definition must be very different, and the constraints of the physiological environment influence such bioreactor design. This review considers the key elements necessary to enable bioreactors to address three main areas associated with biological systems. All entail recreation of the in vivo cell niche as faithfully as possible, so that they may be used to study molecular and cellular changes in normal physiology, with a view to creating tissue-engineered grafts for clinical use; understanding the pathophysiology of disease at the molecular level; defining possible therapeutic targets; and enabling appropriate pharmaceutical testing on a truly representative organoid, thus enabling better drug design, and simultaneously creating the potential to reduce the numbers of animals in research. The premise explored is that not only cellular signalling cues, but also mechano-transduction from mechanical cues, play an important role.

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Developing a Clinically Relevant Tissue Engineered Heart Valve—A Review of Current Approaches

Cited by 31 publications

References 302 publications

Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old

Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old

Biomimetic cardiovascular platforms for in vitro disease modeling and therapeutic validation

Role of Bioreactor Technology in Tissue Engineering for Clinical Use and Therapeutic Target Design

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