Tissue‐Engineered Heart Valve: Future of Cardiac Surgery

Abstract

Background Heart valve disease is currently a growing problem, and demand for heart valve replacement is predicted to increase significantly in the future. Existing ''gold standard'' mechanical and biological prosthesis offers survival at a cost of significantly increased risks of complications. Mechanical valves may cause hemorrhage and thromboembolism, whereas biologic valves are prone to fibrosis, calcification, degeneration, and immunogenic complications. Methods A literature search was performed to identify all relevant studies relating to tissue-engineered heart valve in life sciences using the PubMed and ISI Web of Knowledge databases. Discussion Tissue engineering is a new, emerging alternative, which is reviewed in this paper. To produce a fully functional heart valve using tissue engineering, an appropriate scaffold needs to be seeded using carefully selected cells and proliferated under conditions that resemble the environment of a natural human heart valve. Bioscaffold, synthetic materials, and preseeded composites are three common approaches of scaffold formation. All available evidence suggests that synthetic scaffolds are the most suitable material for valve scaffold formation. Different cell sources of stem cells were used with variable results. Mesenchymal stem cells, fibroblasts, myofibroblasts, and umbilical blood stem cells are used in vitro tissue engineering of heart valve. Alternatively scaffold may be implanted and then autoseeded in vivo by circulating endothelial progenitor cells or primitive circulating cells from patient's blood. For that purpose, synthetic heart valves were developed. Conclusions Tissue engineering is currently the only technology in the field with the potential for the creation of tissues analogous to a native human heart valve, with longer sustainability, and fever side effects. Although there is still a long way to go, tissue-engineered heart valves have the capability to revolutionize cardiac surgery of the future.

Fibroblast Growth on Nanofiber Material Matrices and Changes to Their Mechanical Properties

“…Various polymers -natural and synthetic, their combinations and modified molecules have been tested for different tissue engineering tasks [9]- [11]. Many polymer scaffold types have been used previously for cardiac and cardiac valve tissue engineering [7], [8], [12]. Most interestingly there is recent data that one of our studied polymers -PCL containing several modifications and used in combination with polyethylene glycol can promote cardiomyogenic embryonic stem cell differentiation [13].…”

Biocompatibility Issue Of Tissue Engineered Heart Valves

“…According to the World Health Organization (WHO) in 2005, 17.5 million deaths were due to cardiovascular conditions, which accounts for 30% of the world's mortality. A large proportion of cardiovascular conditions are due to heart valve failure [1]. The demand for heart valve replacement is estimated to grow from 290,000 a year in 2003 to more than 850,000 a year in 2050 [3].…”

“…Currently, heart and cardiovascular-associated conditions are one of the main causes of death worldwide with a constantly growing number of people affected [1,2]. According to the World Health Organization (WHO) in 2005, 17.5 million deaths were due to cardiovascular conditions, which accounts for 30% of the world's mortality.…”

Comparison of Mesenchymal Stem Cell Source Differentiation Toward Human Pediatric Aortic Valve Interstitial Cells within 3D Engineered Matrices

“…More recently, postnatal multipotent stem cells such as mesenchymal stem cells (MSC) have been evaluated as cell sources for TEHV due to their self-renewal capacity and potential for differentiation into several lineages. [12][13][14] Among various MSC sources, bone marrow-derived MSC (BMMSC) and adiposederived MSC (ADMSC) are prime candidates for TEHV due to their greater availability and popularity. [15][16][17][18][19] However, a few studies have compared phenotype and extracellular matrix (ECM) deposition characteristics between MSC and VIC, especially pediatric VIC.…”