Department of Bioengineering, Northeastern University, Boston, Massachusetts.
Department of Bioengineering, University of Texas at Arlington, Arlington, Texas.
Transl Res. 2019 Sep;211:35-45. doi: 10.1016/j.trsl.2019.03.007. Epub 2019 Apr 11.
In children with congenital heart defects, surgical correction often involves the use of valves, patches or vascular conduits to establish anatomic continuity. Due to the differences between the pediatric and adult populations, tissue reconstruction in pediatric patients requires a substantially different approach from those in adults. Cardiovascular anatomy of children with congenital heart defect vary, which requires tailored surgical operations for each patient. Since grafts used in these palliative surgeries are sensitive to the local hemodynamic environments, their geometries need to be precisely designed to ensure long-term performance. Tissue engineered vascular grafts (TEVGs) have made tremendous progress over the past decade, but it remains difficult to fabricate patient- and operation-specific vascular grafts. This review summarizes historical milestones of TEVG development for repairing pediatric congenital defects and current clinical outcomes. We also highlight ongoing works on 3D bioprinting of TEVGs with complex geometries and address the current limitations of each technique. Although 3D bioprinted vascular grafts with appropriate functions are yet to be developed, some of the current researches are promising to create better patient specific tissue engineered vascular grafts in the future.
在患有先天性心脏缺陷的儿童中,手术矫正通常涉及使用瓣膜、补片或血管移植物来建立解剖连续性。由于儿科和成人人群之间存在差异,儿科患者的组织重建需要与成人患者采用截然不同的方法。患有先天性心脏缺陷的儿童的心血管解剖结构存在差异,这需要为每位患者量身定制手术操作。由于这些姑息性手术中使用的移植物对局部血液动力学环境敏感,因此需要精确设计它们的几何形状以确保长期性能。在过去的十年中,组织工程血管移植物 (TEVG) 取得了巨大的进展,但仍然难以制造针对患者和手术的特定血管移植物。这篇综述总结了用于修复儿科先天性缺陷的 TEVG 发展的历史里程碑和当前的临床结果。我们还强调了用于制造具有复杂几何形状的 TEVG 的 3D 生物打印的当前工作,并讨论了每种技术的当前局限性。尽管尚未开发出具有适当功能的 3D 生物打印血管移植物,但目前的一些研究有望在未来创造出更好的患者特异性组织工程血管移植物。