Percutaneous pulmonary valve replacement: autologous tissue-engineered valved stents.

Abstract:

AIMS:Percutaneous implantation has already been used clinically and is a great option for treating young patients. The use of autologous tissue-engineered valved stents might solve the problem of degeneration and limited durability of biological heart valves. METHODS AND RESULTS:Porcine pulmonary heart valves and small intestinal submucosa were obtained from a slaughterhouse. The intestinal submucosa was used to cover the inside of the porcine pulmonary valved stents. Endothelial cells (ECs) and autologous myofibroblasts (MFs) were used from carotid artery segments of juvenile sheep. After MF seeding, constructs were placed in a dynamic bioreactor system and cultured for 16 days. After additional EC seeding, tissue-engineered valved stents were percutaneously deployed into the annulus of the pulmonary valve (n = 9). Angiography was performed at implantation and 4-week follow-up. Constructs were analysed radiographically, by post-mortem examination, and microscopically. In all but one case, orthotopic positioning of the stents (n = 6) at the time of implantation and explantation was observed angiographically, macroscopically, and by computer tomography scan and demonstrated normal valve function (n = 7). Gross morphology confirmed excellent opening and closure characteristics of all leaflets after 4 weeks (n = 7). Strong expression of α-smooth muscle actin in neo-interstitial cells and of von Willebrand factor and PECAM-1 in ECs was revealed by immunocytochemistry. CONCLUSION:Good functioning and morphological characteristics were observed after percutaneous tissue-engineered valved stent implantation with autologous cells. This implantation of autologous tissue-engineered valved stents will become a valid future option in adolescents.

journal_name

Cardiovasc Res

journal_title

Cardiovascular research

authors

Metzner A,Stock UA,Iino K,Fischer G,Huemme T,Boldt J,Braesen JH,Bein B,Renner J,Cremer J,Lutter G

doi

10.1093/cvr/cvq212

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

453-61

issue

3

eissn

0008-6363

issn

1755-3245

pii

cvq212

journal_volume

88

pub_type

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