Tissue Engineered Heart Valve for Aortic Valve Disease. Quo Vadis, Again?

Authors

  • Wilhelm P. Mistiaen Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium, Department of Healthcare Sciences, Artesis-Plantijn University College

Keywords:

Cell source, Scaffold, Bioreactor, In vivo, In vitro, Aortic valve disease

Abstract

Introduction: Heart valve tissue engineering has been presented as a “promising†solution†for over 20 years. These living devices are supposed to have the capacity to grow, heal and repair or remodel. This would avoid structural valve degeneration of currently used biological heart valve prostheses or the need for life-long anticoagulation or mechanical devices. Especially for patients with stenotic aortic valve disease, which is the third most common cardiovascular condition in Western societies, this solution might be useful.

Methods: A literature search has been performed for the years 2010-2014 with focus for results of tissue engineered valves of in-vitro, in-vivo animal and patient studies

Results: Most experiments were still in-vitro. Especially those experiments which focus on synthetic biodegradable scaffolds have not left the laboratory, because these cannot withstand systemic pressures. The animal studies involved scaffolds of biologic origin with or without reseeding with cells. Cells were harvested from vascular, embryonal tissues or from bone marrow. Large animal studies (ovine, porcine) dealt with implantations in pulmonary position and right ventricular reconstruction, which might be useful in the treatment of congenital heart defects. Implantation in the systemic – high pressure – circulation were only performed in small animals (rat model). One goat model showed some remarkable results, but only on very short time.

Conclusions: Tissue engineered valves seemed very promising, a promise that will not be fulfilled soon. Synthetic bioresorbable scaffolds have not left the laboratory yet. Scaffolds of biologic origin already have been tested in animals, mostly in pulmonary origin. It is by no means certain that behavior of tissue engineered valves in animals reflect the clinical situation, which is much more demanding. Also non-scientific hurdles such as official registration and commercialization of such devices have to be taken.

Downloads

Published

2016-03-11

Issue

Vol. 3 No. 1 (2016)

Section

Articles

License

Policy for Journals/Articles with Open Access

Authors who publish with this journal agree to the following terms:
    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

  1. Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work

Policy for Journals / Manuscript with Paid Access

Authors who publish with this journal agree to the following terms:
    1. Publisher retain copyright .

  1. Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .