Performance of allogeneic bioengineered replacement pulmonary valves in rapidly growing young lambs

Quinn, Rachael W.; Bert, Arthur A.; Converse, Gabriel L.; Buse, Eric E.; Hilbert, Stephen L.; Drake, William B.; Hopkins, Richard A.

doi:10.1016/j.jtcvs.2016.05.051

Cited by 14 publications

(8 citation statements)

References 33 publications

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“…Measures to ensure blinding of the investigators and other personnel is often poorly reported in animal studies [ 123 , 124 ]. We have identified only two studies [ 71 , 94 ] that reported blinding of the assessors on valve functionality. Blinding is especially important when it comes to qualitative outcome assessment, particularly if there is a subjective element in the outcome like echocardiographic evaluation of the valve or reading histological slides, both important in TEHV studies.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary valve tissue engineering strategies in large animal models

et al. 2021

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In the last 25 years, numerous tissue engineered heart valve (TEHV) strategies have been studied in large animal models. To evaluate, qualify and summarize all available publications, we conducted a systematic review and meta-analysis. We identified 80 reports that studied TEHVs of synthetic or natural scaffolds in pulmonary position (n = 693 animals). We identified substantial heterogeneity in study designs, methods and outcomes. Most importantly, the quality assessment showed poor reporting in randomization and blinding strategies. Meta-analysis showed no differences in mortality and rate of valve regurgitation between different scaffolds or strategies. However, it revealed a higher transvalvular pressure gradient in synthetic scaffolds (11.6 mmHg; 95% CI, [7.31–15.89]) compared to natural scaffolds (4,67 mmHg; 95% CI, [3,94–5.39]; p = 0.003). These results should be interpreted with caution due to lack of a standardized control group, substantial study heterogeneity, and relatively low number of comparable studies in subgroup analyses. Based on this review, the most adequate scaffold model is still undefined. This review endorses that, to move the TEHV field forward and enable reliable comparisons, it is essential to define standardized methods and ways of reporting. This would greatly enhance the value of individual large animal studies.

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Section: Discussionmentioning

confidence: 99%

Pulmonary valve tissue engineering strategies in large animal models

et al. 2021

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“…This chemical treatment was accomplished by normalizing tissue pH, rehydrating the collagen helix moisture envelope, compacting collagen fibrils, and restoring soluble proteins by treating decellularized valves in a conditioning solution composed of citric acid, hyaluronic acid, lauryl alcohol, and species-specific protein. 12 , 23 , 97 , 98 Biomechanical evaluation revealed that the conditioning solution restored the stress relaxation behavior toward that of the native valve properties. 12 In an ovine allograft valve implant model, the conditioning process led to better hemodynamic performance, compared to cryopreserved and decellularized valves implanted without conditioning.…”

Section: Recellularization and Conditioningmentioning

confidence: 97%

“… 12 In an ovine allograft valve implant model, the conditioning process led to better hemodynamic performance, compared to cryopreserved and decellularized valves implanted without conditioning. 23 , 98 Improved re-endothelialization and matrix recellularization were observed following conditioning, although the interstitial subsurface repopulation was limited to the proximal portion of the leaflet. 23 , 98 Similar results were observed using a baboon model and conditioned human valves to simulate human paradigms.…”

Section: Recellularization and Conditioningmentioning

confidence: 99%

“… 23 , 98 Improved re-endothelialization and matrix recellularization were observed following conditioning, although the interstitial subsurface repopulation was limited to the proximal portion of the leaflet. 23 , 98 Similar results were observed using a baboon model and conditioned human valves to simulate human paradigms. 97 Re-endothelialization and cusp base recellularization were observed in conditioned human valves after 26 weeks, as well as a decrease in class I and class II antibody production compared to cryopreserved valves, indicating reduced antigenicity.…”

Section: Recellularization and Conditioningmentioning

confidence: 99%

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Recellularization of decellularized heart valves: Progress toward the tissue-engineered heart valve

et al. 2017

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The tissue-engineered heart valve portends a new era in the field of valve replacement. Decellularized heart valves are of great interest as a scaffold for the tissue-engineered heart valve due to their naturally bioactive composition, clinical relevance as a stand-alone implant, and partial recellularization in vivo. However, a significant challenge remains in realizing the tissue-engineered heart valve: assuring consistent recellularization of the entire valve leaflets by phenotypically appropriate cells. Many creative strategies have pursued complete biological valve recellularization; however, identifying the optimal recellularization method, including in situ or in vitro recellularization and chemical and/or mechanical conditioning, has proven difficult. Furthermore, while many studies have focused on individual parameters for increasing valve interstitial recellularization, a general understanding of the interacting dynamics is likely necessary to achieve success. Therefore, the purpose of this review is to explore and compare the various processing strategies used for the decellularization and subsequent recellularization of tissue-engineered heart valves.

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“…The report by Quinn and colleagues 1 provides a comparison of cryopreserved (CP) homograft pulmonary valves with pulmonary homograft valves that were bioengineered (BE) by decellularization and then conditioned with a unique solution of fatty alcohol containing human hyaluronin immediately before implantation in growing sheep. After 6 months, the authors found cellular ingrowth into both the BE and CP valved conduit grafts, but the extent of surface coverage of the BE valves was greater.…”

mentioning

confidence: 99%