Barzilla Janet E, Blevins Tracy L, Grande-Allen K Jane
Department of Bioengineering, Rice University, Houston, TX 77251-1892, USA.
Am J Geriatr Cardiol. 2006 Sep-Oct;15(5):311-5.
Elderly patients would receive substantial benefits from tissue-engineered heart valves (TEHVs), but most TEHV research has not focused on applications for this growing patient population. There will be numerous technical challenges involved in developing TEHVs for the elderly, such as designing tissues to accommodate higher blood pressure and larger aortic roots that may be friable or calcified. Concomitant medications may also affect the biology of the TEHV. Due to the predominantly senescent behavior of cells from older persons, a nonautologous cell source may be required to develop the TEHV. Decellularized heart valve allografts from elderly donors may not be durable enough to use as a scaffold, but several polymer and natural biodegradable scaffolds may provide promising alternatives. The selection of cell sources, scaffolds, and mechanical/biologic conditioning will need to be precisely targeted to meet the diverse physiological, medical, and surgical requirements of elderly patients.
老年患者将从组织工程心脏瓣膜（TEHV）中获得巨大益处，但大多数TEHV研究并未聚焦于这一不断增长的患者群体的应用。为老年人开发TEHV将涉及众多技术挑战，例如设计组织以适应更高的血压以及可能脆弱或钙化的更大主动脉根部。同时服用的药物也可能影响TEHV的生物学特性。由于老年人细胞主要表现为衰老行为，可能需要非自体细胞来源来开发TEHV。来自老年供体的脱细胞心脏瓣膜同种异体移植物可能不够耐用，无法用作支架，但几种聚合物和天然可生物降解支架可能提供有前景的替代方案。细胞来源、支架以及机械/生物预处理的选择需要精准定位，以满足老年患者多样的生理、医学和手术需求。
