Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

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• 作者：Jay Reimer ; Zeeshan Syedain ; Bee Haynie ; Matthew Lahti…
• 关键词：Heart valve ; Tissue engineering ; Congenital heart defects ; Matrix remodeling ; Pediatric
• 刊名：Annals of Biomedical Engineering
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：45
• 期：2
• 页码：439-451
• 全文大小：
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine, general; Biomedical Engineering; Biological and Medical Physics, Biophysics; Classical Mechanics; Biochemistry, general;
• 出版者：Springer US
• ISSN：1573-9686
• 卷排序：45

文摘

Current pediatric heart valve replacement options are suboptimal because they are incapable of somatic growth. Thus, children typically have multiple surgeries to replace outgrown valves. In this study, we present the in vivo function and growth potential of our tissue-engineered pediatric tubular valve. The valves were fabricated by sewing two decellularized engineered tissue tubes together in a prescribed pattern using degradable sutures and subsequently implanted into the main pulmonary artery of growing lambs. Valve function was monitored using periodic ultrasounds after implantation throughout the duration of the study. The valves functioned well up to 8 weeks, 4 weeks beyond the suture strength half-life, after which their insufficiency index worsened. Histology from the explanted valves revealed extensive host cell invasion within the engineered root and commencing from the leaflet surfaces. These cells expressed multiple phenotypes, including endothelial, and deposited elastin and collagen IV. Although the tubes fused together along the degradable suture line as designed, the leaflets shortened compared to their original height. This shortening is hypothesized to result from inadequate fusion at the commissures prior to suture degradation. With appropriate commissure reinforcement, this novel heart valve may provide the somatic growth potential desired for a pediatric valve replacement.