Angiology: Open Access
Open Access

Tissue Engineering Approaches for Developing Biomimetic Artificial Heart Valves

Melissa Joseph^{* *}Correspondence: Melissa Joseph, Department of Cardiology, University of Geneva, Geneva, Switzerland, Email:

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Description

Heart valve diseases represent a significant health burden worldwide, often requiring surgical intervention to repair or replace damaged valves. While mechanical and bioprosthetic valves have been the conventional choices for replacement, they come with inherent limitations such as thrombogenicity, limited durability, and lack of growth potential in younger patients. Tissue engineering optimistic alternative by aiming to create living, biomimetic heart valves that mimic the structure, function, and mechanical properties of native valves. This article explores the innovative tissue engineering approaches driving the development of biomimetic artificial heart valves.

Valve structure and function

To engineer biomimetic heart valves, it is essential to comprehend the intricate structure and dynamic function of native valves. Heart valves are composed of specialized Extracellular Matrix (ECM) primarily consisting of collagen, elastin, Glycosaminoglycans (GAGs), and Valve Interstitial Cells (VICs). These cells play an important role in maintaining valve homeostasis, remodeling, and response to mechanical cues. The valve leaflets exhibit anisotropic mechanical properties, allowing for efficient opening and closing during the cardiac cycle. Mimicking these characteristics is key to creating functional biomimetic valves.

Biomaterial selection and scaffold design

Biomaterials play a pivotal role in tissue engineering heart valves, providing structural support, biocompatibility, and cues for cellular adhesion and growth. Various natural and synthetic biomaterials have been explored for scaffold fabrication, including decellularized ECM, biodegradable polymers, and hydrogels. Decellularized ECM offers a biomimetic microenvironment by preserving native ECM architecture and biochemical cues. Synthetic polymers provide tunable mechanical properties and degradation rates, crucial for valve functionality and remodeling. Scaffold design strategies involve techniques such as electrospinning, 3D bioprinting, and selfassembly to create anatomically accurate and mechanically robust constructs.

Cell sourcing and seeding strategies

Cellularization of scaffolds with VICs or stem/progenitor cells is essential for creating living, functional heart valve substitutes. VICs exhibit phenotypic plasticity, transitioning between quiescent, activated, and myofibroblastic states in response to mechanical and biochemical cues. Autologous cell sourcing offers the advantage of immunocompatibility but may pose challenges in scalability and availability. Alternatively, stem/ progenitor cells derived from sources like bone marrow, adipose tissue, or induced Pluripotent Stem Cells (iPSCs) provides the potential for personalized shelf valve constructs. Cell seeding techniques, including static seeding, dynamic seeding, and cell sheet engineering, aim to achieve homogeneous cell distribution and tissue integration within the scaffold.

Biomimetic valve maturation and functional assessment

Post-seeding, biomimetic valve constructs undergo maturation and functionalization to resemble native valves. Dynamic culture systems employing bioreactors simulate physiological conditions, promoting tissue remodeling, ECM deposition, and mechanical conditioning. Bioreactors can apply cyclic mechanical strain, perfusion flow, and biochemical stimuli to mimic the hemodynamic environment and enhance cellular alignment and ECM organization. Functional assessment techniques such as mechanical testing, histological analysis, and in vitro/in vivo hemodynamic evaluation provide insights into valve performance, durability, and compatibility.

Overcoming immunogenicity challenges

One of the primary concerns in tissue engineering is the potential for immune rejection of implanted constructs. Researchers are exploring various strategies to mitigate immunogenicity, including decellularization techniques, immunomodulatory coatings, and patient-specific cell sourcing. By minimizing immune responses, tissue-engineered heart valves can achieve better integration and long-term functionality.

Challenges and future perspectives

Despite significant progress, several challenges remain in tissue engineering biomimetic heart valves. Achieving long-term durability, immunological compatibility, and integration with host tissue poses considerable hurdles. Optimization of scaffold design, biomaterial selection, and cell sourcing strategies is imperative to overcome these challenges. Future research efforts will focus on refining biomaterials, enhancing tissue maturation and functionality, and developing personalized approaches to provide needs for individual patients.

Conclusion

Tissue engineering holds tremendous potential for revolutionizing the field of cardiac care by providing biomimetic solutions for heart valve replacement. By controlling the principles of biology and engineering, researchers are facilitate for safer, more durable, and patient-specific treatments. As technology continues to advance, biomimetic artificial heart valves have the potential to become the standard in cardiac surgery, improving outcomes and quality of life for patients worldwide.