Tissue Engineering of Heart Valves

Hopkins, Richard A.

doi:10.1161/circulationaha.104.527820

Cited by 39 publications

(9 citation statements)

References 21 publications

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“…In one approach, synthetic or natural polymer scaffolds are created in a mold or platform. Other groups use xenografts as their scaffold starting material, chemically or physically altering the structure prior to additional work [26]. The primary function of heart valves is the unidirectional flow of blood, which places significant mechanical forces on the leaflets during a cardiac cycle.…”

Section: How Tissue Engineering Can Improve Heart Valve Replacementsmentioning

confidence: 99%

EMT-Inducing Biomaterials for Heart Valve Engineering: Taking Cues from Developmental Biology

Sewell-Loftin

Chun

Khademhosseini

et al. 2011

J. of Cardiovasc. Trans. Res.

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Although artificial prostheses for diseased heart valves have been around for several decades, viable heart valve replacements have yet to be developed due to their complicated nature. The majority of research in heart valve replacement technology seeks to improve decellularization techniques for porcine valves or bovine pericardium as an effort to improve current clinically used valves. The drawback of clinically used valves is that they are nonviable and thus do not grow or remodel once implanted inside patients. This is particularly detrimental for pediatric patients, who will likely need several reoperations over the course of their lifetimes to implant larger valves as the patient grows. Due to this limitation, additional biomaterials, both synthetic and natural in origin, are also being investigated as novel scaffolds for tissue engineered heart valves, specifically for the pediatric population. Here, we provide a brief overview of valves in clinical use as well as of the materials being investigated as novel tissue engineered heart valve scaffolds. Additionally, we focus on natural-based biomaterials for promoting cell behavior that is indicative of the developmental biology process that occurs in the formation of heart valves in utero, such as epithelial-to-mesenchymal transition or transformation (EMT). By engineering materials that promote native developmental biology cues and signaling, while also providing mechanical integrity once implanted, a viable tissue engineered heart valve may one day be realized. A viable tissue engineered heart valve, capable of growing and remodeling actively inside a patient, could reduce risks and complications associated with current valve replacement options and improve overall quality of life in the thousands of patients who received such valves each year, particularly for children.

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Section: How Tissue Engineering Can Improve Heart Valve Replacementsmentioning

confidence: 99%

EMT-Inducing Biomaterials for Heart Valve Engineering: Taking Cues from Developmental Biology

Sewell-Loftin

Chun

Khademhosseini

et al. 2011

J. of Cardiovasc. Trans. Res.

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“…These heart valves have the advantage of enhancing cellular attachment and retaining many of the mechanical and structural properties such as tensile strength and the unique extracellular matrix composition of the aortic heart valve. 6 During the decellularization of the porcine aortic heart valves, endothelial cells that cover the surface of the valve, interstitial fibroblasts, smooth muscle cells, and myofibroblasts and proteoglycans are removed. Finally, a matrix consisting of merely collagen and elastin remains.…”

Section: Introductionmentioning

confidence: 99%

Layer-by-Layer Incorporation of Growth Factors in Decellularized Aortic Heart Valve Leaflets

et al. 2010

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Aortic heart valve disease is a growing health problem and a tissue-engineered aortic heart valve could be a promising therapy. In this paper, decellularized porcine aortic heart valve leaflets are used as scaffolds and loaded with growth factor and heparin via layer-by-layer electrostatic deposition (LbL technique) with the final purpose to stimulate and control cellular processes. Binding and subsequent release of heparin and basic fibroblast growth factor (bFGF) from aortic valve leaflets were assessed qualitatively by immunohistochemistry and quantitatively by radioactive labeling methods. It was observed that the amount of heparin and bFGF bound to aortic heart valve leaflets was directly proportional to the concentration of heparin and bFGF in the incubation medium. Release of heparin and bFGF from the decellularized heart valve leaflets at physiological conditions was sustained over 4 days while preserving the biological activity of the released growth factor.

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“…GA fixation devitalizes but does not remove connective tissue cells that are prone to be the initial site of calcium deposition. Calcification of the extracellular matrix structural proteins collagen and elastin has been studied; collagen and elastic fibers can serve as nucleation sites for calcium phosphate minerals, independent of cellular components [9].…”

Section: Commentsmentioning

confidence: 99%

Does the Animal Origin Influence the Calcification of Xenograft Tissue Heart Valve Substitutes? Comparison between Bovine and Camel Pericardium in a Subcutaneous Rat Model

Harmoodi¹,

Shafy²,

Guichardant³

et al. 2015

IJCM

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Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± * Corresponding author. F. Al Harmoodi et al. 7010.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns); collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.

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Tissue Engineering of Heart Valves

Cited by 39 publications

References 21 publications

EMT-Inducing Biomaterials for Heart Valve Engineering: Taking Cues from Developmental Biology

EMT-Inducing Biomaterials for Heart Valve Engineering: Taking Cues from Developmental Biology

Layer-by-Layer Incorporation of Growth Factors in Decellularized Aortic Heart Valve Leaflets

Does the Animal Origin Influence the Calcification of Xenograft Tissue Heart Valve Substitutes? Comparison between Bovine and Camel Pericardium in a Subcutaneous Rat Model

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