Next-generation tissue-engineered heart valves with repair, remodelling and regeneration capacity

Fioretta, Emanuela S.; Motta, Sarah E.; Lintas, Valentina; Loerakker, Sandra; Parker, Kevin Kit; Baaijens, Fpt Frank; Falk, Volkmar; Hoerstrup, Simon P.; Emmert, MY

doi:10.1038/s41569-020-0422-8

Cited by 151 publications

(136 citation statements)

References 244 publications

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“…Since then, a significant amount of research has been conducted to regenerate different tissues, as indicated by the number of publications on the regeneration each of skin, cartilage, bone, and heart-valves ( Figure 1 ). Skin and bone regeneration gained the most interest of researchers due to their simplicity compared to heart valves, which required specialized structures [ 35 ]. However, with the development in material science and fabrication techniques, particularly the use of 3D printing technologies to print biopolymer-based scaffolds, many specialized and highly accurate scaffolds have been successfully fabricated for the regeneration of most body tissues, including heart-valves [ 68 ].…”

Section: Tissue Scaffolding and Regenerative Medicinementioning

confidence: 99%

“…Biopolymer-based aerogels have been widely investigated and reviewed for their properties [ 24 ], fabrication techniques [ 25 ], biocompatibility [ 26 ], and cytotoxicity [ 27 , 28 ]; many studies have revealed their potential in tissue engineering as well as other biomedical applications [ 25 , 29 , 30 , 31 ]. Previous reviews either explain a single type of tissue regeneration such as skin [ 32 ], bone [ 33 ], cartilage [ 34 ], or valves [ 35 ], and many of these reviews focus on a particular scaffold-based material such as chitosan [ 36 ] or cellulose [ 37 ]. Furthermore, biopolymer hydrogel-based scaffolds have been extensively reviewed in many previous reviews, including [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

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Insights into the Role of Biopolymer Aerogel Scaffolds in Tissue Engineering and Regenerative Medicine

et al. 2021

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The global transplantation market size was valued at USD 8.4 billion in 2020 and is expected to grow at a compound annual growth rate of 11.5% over the forecast period. The increasing demand for tissue transplantation has inspired researchers to find alternative approaches for making artificial tissues and organs function. The unique physicochemical and biological properties of biopolymers and the attractive structural characteristics of aerogels such as extremely high porosity, ultra low-density, and high surface area make combining these materials of great interest in tissue scaffolding and regenerative medicine applications. Numerous biopolymer aerogel scaffolds have been used to regenerate skin, cartilage, bone, and even heart valves and blood vessels by growing desired cells together with the growth factor in tissue engineering scaffolds. This review focuses on the principle of tissue engineering and regenerative medicine and the role of biopolymer aerogel scaffolds in this field, going through the properties and the desirable characteristics of biopolymers and biopolymer tissue scaffolds in tissue engineering applications. The recent advances of using biopolymer aerogel scaffolds in the regeneration of skin, cartilage, bone, and heart valves are also discussed in the present review. Finally, we highlight the main challenges of biopolymer-based scaffolds and the prospects of using these materials in regenerative medicine.

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Section: Tissue Scaffolding and Regenerative Medicinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Insights into the Role of Biopolymer Aerogel Scaffolds in Tissue Engineering and Regenerative Medicine

et al. 2021

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“…Further work in this field has sought to define an ideal PVR, with the goal of creating an “off-the-shelf” TEPV capable of self-renewal and growth within pediatric patients. While the concept of tissue engineering encompasses advantages over current technology [ 38 ], this section will focus solely on select studies regarding synthetic, bioabsorbable TEPV scaffolds.…”

Section: Tissue-engineered Pulmonary Valvementioning

confidence: 99%

The Real Need for Regenerative Medicine in the Future of Congenital Heart Disease Treatment

et al. 2021

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Bioabsorbable materials made from polymeric compounds have been used in many fields of regenerative medicine to promote tissue regeneration. These materials replace autologous tissue and, due to their growth potential, make excellent substitutes for cardiovascular applications in the treatment of congenital heart disease. However, there remains a sizable gap between their theoretical advantages and actual clinical application within pediatric cardiovascular surgery. This review will focus on four areas of regenerative medicine in which bioabsorbable materials have the potential to alleviate the burden where current treatment options have been unable to within the field of pediatric cardiovascular surgery. These four areas include tissue-engineered pulmonary valves, tissue-engineered patches, regenerative medicine options for treatment of pulmonary vein stenosis and tissue-engineered vascular grafts. We will discuss the research and development of biocompatible materials reported to date, the evaluation of materials in vitro, and the results of studies that have progressed to clinical trials.

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“…Conventional approaches to deliver growing heart valve replacement are based on tissue engineering or mechanical engineering but these approaches have failed in clinical translation (5)(6)(7)(8)(9). This is a critical barrier to progress in the field.…”

Section: Introductionmentioning

confidence: 99%

Cellular Viability of Partial Heart Transplant Grafts in Cold Storage

et al. 2021

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Congenital heart defects are the most common types of birth defects in humans. Children with congenital heart defects frequently require heart valve replacement with an implant. Unfortunately, conventional heart valve implants do not grow. Therefore, these children are committed to serial re-operations for successively larger implant exchanges. Partial heart transplantation is a new and innovative approach to deliver growing heart valve implants. However, the transplant biology of partial heart transplant grafts remains unexplored. This is a critical barrier for clinical translation. Therefore, we investigated the cellular viability of partial heart transplants in cold storage. Histology and immunohistochemistry revealed no morphological differences in heart valves after 6, 24, or 48 h of cold storage. Moreover, immunohistochemistry showed that the marker for apoptosis activated caspase 3 and the marker for cell division Ki67 remained unchanged after 48 h of cold storage. Finally, quantification of fluorescing resorufin showed no statistically significant decrease in cellular metabolic activity in heart valves after 48 h of cold storage. We conclude that partial heart transplants remain viable after 48 h of cold storage. These findings represent the first step toward translating partial heart transplantation from the bench to the bedside because they have direct clinical implications for the procurement logistics of this new type of transplant.

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Next-generation tissue-engineered heart valves with repair, remodelling and regeneration capacity

Abstract: M. Y. (2021). Next-generation tissue-engineered heart valves with repair, remodelling and regeneration capacity. Nature Reviews Cardiology, 18(2), 92-116.

Cited by 151 publications

References 244 publications

Insights into the Role of Biopolymer Aerogel Scaffolds in Tissue Engineering and Regenerative Medicine

Insights into the Role of Biopolymer Aerogel Scaffolds in Tissue Engineering and Regenerative Medicine

The Real Need for Regenerative Medicine in the Future of Congenital Heart Disease Treatment

Cellular Viability of Partial Heart Transplant Grafts in Cold Storage

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