Department of Cardiothoracic Surgery, Amsterdam University Medical Centers location University of Amsterdam, Amsterdam, The Netherlands.
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Commun Biol. 2023 Nov 14;6(1):1166. doi: 10.1038/s42003-023-05533-3.
Pliable microfibrous, bioresorbable elastomeric heart valve prostheses are investigated in search of sustainable heart valve replacement. These cell-free implants recruit cells and trigger tissue formation on the valves in situ. Our aim is to investigate the behaviour of these heart valve prostheses when exposed to the high-pressure circulation. We conducted a 12-month follow-up study in sheep to evaluate the in vivo functionality and neo-tissue formation of these valves in the aortic position. All valves remained free from endocarditis, thrombotic complications and macroscopic calcifications. Cell colonisation in the leaflets was mainly restricted to the hinge area, while resorption of synthetic fibers was limited. Most valves were pliable and structurally intact (10/15), however, other valves (5/15) showed cusp thickening, retraction or holes in the leaflets. Further research is needed to assess whether in-situ heart valve tissue engineering in the aortic position is possible or whether non-resorbable synthetic pliable prostheses are preferred.
研究了柔韧的微纤维、生物可吸收弹性心脏瓣膜假体，以寻求可持续的心脏瓣膜置换。这些无细胞植入物在原位招募细胞并触发组织形成在瓣膜上。我们的目的是研究这些心脏瓣膜假体在暴露于高压循环时的行为。我们在绵羊中进行了为期 12 个月的随访研究，以评估这些瓣膜在主动脉位置的体内功能和新组织形成。所有瓣膜均未发生心内膜炎、血栓并发症和宏观钙化。瓣叶中的细胞定植主要局限于铰链区，而合成纤维的吸收有限。大多数瓣膜仍然柔韧且结构完整（10/15），然而，其他瓣膜（5/15）显示瓣叶增厚、收缩或出现孔。需要进一步研究，以评估在主动脉位置进行原位心脏瓣膜组织工程是否可行，或者是否更倾向于不可吸收的合成柔韧假体。
