Heart valve and myocardial tissue engineering.
Summary of "Heart valve and myocardial tissue engineering."
Cardiac function, including the heart muscle and valves, can be severely altered by congenital and acquired heart diseases. Several graft materials are currently used to replace diseased cardiac tissue and valvular segments. Implantable grafts are either non-vital or can trigger an immune response which leads to graft calcification and degeneration. None of the existing grafts have the ability to remodel and grow in tandem with the physiological growth of a child and therefore require re-operation. Novel approaches such as tissue engineering have emerged as possible alternatives for cardiac reconstruction. The main concept of tissue engineering includes the use of biological and artificial scaffolds that form the shape of the organ structures for subsequent tissue replacement, which will provide absolute biocompatibility, no thrombogenicity, no teratogenicity, long-term durability and growth.Heart valve tissue engineering represents an important field especially in pediatric patients with valve pathologies. In order to create an autologous valve equivalent myofibroblasts and/or endothelial cells are seeded on specially designed scaffolds. Here we describe the different types of cell sources and different types of matrices currently used in heart valve tissue engineering. Valve manufacture is carried out in specially designed bioreactors providing physiological conditions. The number of clinical studies using tissue engineered valves is still limited; however, several promising results have already demonstrated their durability and ability to grow.Myocardial tissue engineering aims to repair, replace and regenerate damaged cardiac tissue using tissue constructs created ex vivo. Conceivable indications for clinical application of tissue engineered myocardial-implant substitutes include ischemic cardiomyopathies, as well as right ventricular outflow tract reconstruction in patients with congenital heart diseases. Therapeutic application of functional (contractile) tissue engineered heart muscle appears feasible once key issues such as identification of the suitable human cell source, large scale expansion and suitable scaffolds are solved. In addition, the present article discusses the importance of vascularization as an important prerequisite for successful bio-artificial myocardial tissue.Further experimental and clinical research on cardiovascular tissue engineering is felt to be of great importance for others as well as for us in order to create an ideal heart valve/myocardial substitute and help our patients with advanced cardiac pathologies.
Klinik für Herz-, Thorax-, Transplantations- und Gefässchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland, firstname.lastname@example.org.
This article was published in the following journal.
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20631970
- DOI: http://dx.doi.org/10.1007/s00059-010-3355-x
Heart valve-related disorders are among the major causes of death worldwide. Although prosthetic valves are widely used to treat this pathology, current prosthetic grafts cannot grow with the patient...
Post-myocardial infarction (MI) mitral regurgitation (MR) is thought to be due to a passive, rather than active, remodeling of the mitral valve apparatus and its relationship with other cardiac struct...
Modeling integrated human physiology in vitro is a formidable task not yet achieved with any of the existing cell/tissue systems. However, tissue engineering is becoming increasingly successful at aut...
Mitral valve surgery after previous cardiac surgery is technically demanding and risky. In patients after coronary artery bypass grafting (CABG), mitral valve surgery is associated with a high risk of...
TAVI is the treatment of choice for patients with severe symptomatic aortic stenosis (AS) who are at high surgical risk. AS results in changes in myocardial strain and twist. Myocardial strain, strain...
This is a trial to demonstrate the safety and effectiveness of the Mitroflow Aortic Heart Valve when used to replace a diseased or dysfunctional aortic valve or aortic valve prosthesis.
This study is to try to maintain cultured dermal papilla cells in spherical structure in vitro before transplanting into dermis in vivo. Also, this study is aimed in clarifying actual mech...
People with coronary artery disease (CAD) or people who have had a heart attack may develop a leak in the mitral valve of their heart and may therefore need to undergo surgery to fix the v...
The purpose of this study is to compare sizing,implant techniques, and hemodynamics between the Mitroflow Pericardial Aortic Valve and the Edwards Magna Heart Valve.
The purpose of this study is to compare the sound pressure levels (SPLs) from three of the most frequently implanted mechanical heart valve prostheses, in order to determine whether there...
Medical and Biotech [MESH] Definitions
A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annuli of HEART VALVES. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
A condition caused by underdevelopment of the whole left half of the heart. It is characterized by hypoplasia of the left cardiac chambers (HEART ATRIUM; HEART VENTRICLE), the AORTA, the AORTIC VALVE, and the MITRAL VALVE. Severe symptoms appear in early infancy when DUCTUS ARTERIOSUS closes.
A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annulus of the MITRAL VALVE. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.
Downward displacement of any one of the HEART VALVES from its normal position. This usually results in failed valve closure.