Biodegradable synthetic polymeric composite scaffold‐based tissue engineered heart valve with minimally invasive transcatheter implantation

Abstract

Prosthetic heart valve replacement is the main treatment for valvular heart disease, but the existing artificial valves (mechanical or biological valve) have inherent disadvantages. Patients with mechanical valves require lifelong anticoagulation because of the high risk of thromboembolism, while the durability of biological valve is poor, which easily leads to calcification or lobular degeneration. Besides, they all lack the abilities of self‐repair and growth which are very important for adolescent patients with valvular heart disease. To overcome these shortcomings, the researchers developed tissue engineered heart valves (TEHV) with self‐repairing and remodeling capabilities, low immunogenicity, and great durability. The preparation of three‐dimensional porous scaffolds is the key step in the success of TEHV. Because of their easy processing, active chemical properties, great mechanical properties and controllable degradation rate, synthetic biodegradable polymers are widely used in the preparation of TEHV scaffolds. This review summarizes the types, properties and process techniques of biodegradable synthetic polymers, such as polycaprolactone, polyglycolic acid, polylactic acid, and polyhydroxyalkanoates currently used to prepare the TEHV scaffolds. This review also focuses on the composite methods and performance of synthetic polymer‐based composite scaffolds. The prospects and challenges of the clinical application for minimally invasive implantation of TEHV are also discussed.

Fabrication of Biomedical Scaffolds Using Biodegradable Polymers

“…Acute cardiovascular injuries, such as myocardial infarctions (MI), occur when the blood supply to the cardiac muscle is blocked, resulting in cardiac muscle death, reduced cardiac function, and eventually pathological remodeling of the heart that permanently prevents functional restoration of the tissue. Treatments for cardiovascular disease range from stent placement to bypass grafts to heart valve replacement …”

“…Treatments for cardiovascular disease range from stent placement to bypass grafts to heart valve replacement. 409 Thus, an attractive solution to treat cardiovascular disease is through the fabrication of personalized scaffolds. Ideally, these scaffolds should be able to deliver stem cells to increase cell retention and viability in the ischemic tissue.…”

Algal-derived macromolecules and their composites: From synthetic biology to biomedical applications in bone and cardiovascular tissue engineering

“…Therefore, further exploration is needed to maintain the sustainability and availability of these artificial valves through alternative algal-derived macromolecule uses (Rastogi and Kandasubramanian, 2019;Benko et al, 2022). Artificial heart valves are obtained through synthetic biology by engineering scaffold-based tissues from biodegradable synthetic polymer composites (Rippel, Ghanbari, and Seifalian, 2012;Long et al, 2020). At least 12% of patients aged >75 years suffer from heart valve disease (Oh et al, 2020).…”

“…Patients with mechanical valves require lifelong anticoagulation due to high thromboembolism risk, while biological valve resistance is poor, rapidly leading to calcification or lobular degeneration. To address these deficiencies, researchers developed a tissue-engineered heart valve with repair and remodeling capabilities, low immunogenicity, and high durability from algal-derived macromolecules (Long et al, 2020;Chandika et al, 2020).…”

Biodegradable cross‐linked poly(1,3‐trimethylene carbonate) networks formed by gamma irradiation under vacuum

“…Compared with metal materials and nondegradable polymer materials, biodegradable polymers have the advantage of not requiring secondary surgery 3 . In recent decades, polylactic acid, 4 polycaprolactone, 5 polyglycolic acid, 6 and other absorbable polymer materials are increasingly favored by researchers 7,8 …”