Prosthetic heart valves: Catering for the few

Children’s heart disease in sub-Saharan Africa: Challenging the burden of disease

“…(20) Yet RHD remains the most common form of cardiac disease in children and young adults in Africa and a major public health concern. (16) It is the most preventable form of cardiac disease, though difficult to treat effectively without surgery, (13) which is expensive, generally unavailable, and involves high-cost prostheses; (20) it is also only a partial solution, especially in a [95][96][97][98][99] FIGUrE 1: Age pyramid: south Africa the South African age pyramid illustrates the classic prominent "youth bulge" of developing nations. the bulk of the population is under 25 years old, the age group most affected by the twin epidemics of acquired (rheumatic) and congenital heart disease.…”

“…is directed toward first-world needs for both pharmaceuticals and technology. (95) Other approaches that were commonplace in the early days of cardiac surgery could be appropriate for developing nations unable to afford high tech developments. For example, closed mitral valvotomy using a Logan-Tubbs dilator, which cheaply and effectively saved thousands of lives from 1954 into the 1980s before expensive catheter-based alternatives came into vogue.…”

Prosthetic Aortic Valves: A Surgical and Bioengineering Approach

“…In other words, they cannot grow up and remodelled with patient. Tissue engineering is a recent technological approach in the construction of artificial implants that can be gradually remodelled into the patient in real living tissue and organs, following regeneration and auto repair capabilities similar to that of the other natural patient body components (Kretlow & Mikos, 2008;Zilla et al, 2008). Attempts for the construction of TE implants are spread to different tissues and organs, like dermal parches, cartilage, bone and cardiovascular implants and TE or hybrid organs like pancreas or liver.…”

Tissue engineering on matrix: future of autologous tissue replacement

“…Additionally, mechanical valve substitutes are inherently susceptible to thromboembolic events due to high shear stress, nonphysiological flow profiles, and blood damage necessitating lifelong anticoagulation therapy [2,3]. Bioprostheses from xenogenic or homogenic origin are inherently prone to structural degeneration, and the associated need for repeat reoperations makes them less suitable for many patients [4,5]. Tissue engineering of heart valves represents a technology with the potential to overcome these limitations by creating a living autologous valve replacement that prevents an immune response, clotting activation, and valvular degeneration on the one hand, and allows for growth, remodeling, and repair throughout the patient's lifetime on the other hand.…”