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Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

  • The Pursuit of Engineering the Ideal Heart Valve Replacement or Repair
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Abstract

Current pediatric heart valve replacement options are suboptimal because they are incapable of somatic growth. Thus, children typically have multiple surgeries to replace outgrown valves. In this study, we present the in vivo function and growth potential of our tissue-engineered pediatric tubular valve. The valves were fabricated by sewing two decellularized engineered tissue tubes together in a prescribed pattern using degradable sutures and subsequently implanted into the main pulmonary artery of growing lambs. Valve function was monitored using periodic ultrasounds after implantation throughout the duration of the study. The valves functioned well up to 8 weeks, 4 weeks beyond the suture strength half-life, after which their insufficiency index worsened. Histology from the explanted valves revealed extensive host cell invasion within the engineered root and commencing from the leaflet surfaces. These cells expressed multiple phenotypes, including endothelial, and deposited elastin and collagen IV. Although the tubes fused together along the degradable suture line as designed, the leaflets shortened compared to their original height. This shortening is hypothesized to result from inadequate fusion at the commissures prior to suture degradation. With appropriate commissure reinforcement, this novel heart valve may provide the somatic growth potential desired for a pediatric valve replacement.

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Acknowledgments

The authors acknowledge technical assistance from Sandy Johnson, Naomi Ferguson, Susan Saunders, the UMN Medical Devices Center, and the staff of the UMN Experimental Surgical Services and funding from NIH R01 HL107572 to R.T.T.

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Authors and Affiliations

  1. Department of Biomedical Engineering, University of Minnesota, 312 Church St SE, Minneapolis, MN, 55455, USA

    Jay Reimer, Zeeshan Syedain, Bee Haynie & Robert Tranquillo

  2. Experimental Surgical Services, University of Minnesota, Minneapolis, MN, USA

    Matthew Lahti & James Berry

  3. Department of Chemical Engineering and Material Science, University of Minnesota, Minneapolis, MN, USA

    Robert Tranquillo

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  1. Jay Reimer
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  2. Zeeshan Syedain
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Correspondence to Robert Tranquillo.

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Associate Editor Lakshmi Prasad Dasi oversaw the review of this article.

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Reimer, J., Syedain, Z., Haynie, B. et al. Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs. Ann Biomed Eng 45, 439–451 (2017). https://doi.org/10.1007/s10439-016-1605-7

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  • DOI: https://doi.org/10.1007/s10439-016-1605-7

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