Acute In Vivo Functional Assessment of a Biodegradable Stentless Elastomeric Tricuspid Valve
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ORIGINAL ARTICLE
Acute In Vivo Functional Assessment of a Biodegradable Stentless Elastomeric Tricuspid Valve Garrett N. Coyan 1,2,3 & Lindemberg da Mota Silveira-Filho 2 & Yasumoto Matsumura 2,3 & Samuel K. Luketich 2,3 & William Katz 1 & Vinay Badhwar 2,4 & William R. Wagner 2,3 & Antonio D’Amore 2,3,5 Received: 8 November 2019 / Accepted: 21 January 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Degradable heart valves based on in situ tissue regeneration have been proposed as potentially durable and nonthrombogenic prosthetic alternatives. We evaluated the acute in vivo function, microstructure, mechanics, and thromboresistance of a stentless biodegradable tissue-engineered heart valve (TEHV) in the tricuspid position. Biomimetic stentless tricuspid valves were fabricated with poly(carbonate urethane)urea (PCUU) by doublecomponent deposition (DCD) processing to mimic native valve mechanics and geometry. Five swine then underwent 24-h TEHV implantation in the tricuspid position. Echocardiography demonstrated good leaflet motion and no prolapse and trace to mild regurgitation in all but one animal. Histology revealed patches of proteinaceous deposits with no cellular uptake. SEM demonstrated retained scaffold microarchitecture with proteinaceous deposits but no platelet aggregation or thrombosis. Explanted PCUU leaflet thickness and mechanical anisotropy were comparable with native tricuspid leaflets. Bioinspired, elastomeric, stentless TEHVs fabricated by DCD were readily implantable and demonstrated good acute function in the tricuspid position. Keywords Tissue-engineered heart valve . Tricuspid valve replacement . Double-component deposition . Electrospinning . In vivo study . Biodegradable valve prosthesis
Abbreviations DCD Double-component deposition EE Epicardial echocardiography PCUU Poly(carbonate urethane)urea SEM Scanning electron micrography TEHV Tissue-engineered heart valve
Read at the 99th Annual Meeting of the American Association for Thoracic Surgery on May 5, 2019. Associate Editor Marat Fudim oversaw the review of this article Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12265-020-09960-z) contains supplementary material, which is available to authorized users. * Antonio D’Amore [email protected] 1
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
2
McGowan Institute for Regenerative Medicine, Bridgeside Point 2 Building, 450 Technology Dr., Suite 300, Pittsburgh, PA 15219, USA
3
University of Pittsburgh, Pittsburgh, PA, USA
4
West Virginia University, Morgantown, WV, USA
5
RiMED Foundation, Palermo, Italy
Introduction The number of patients requiring life-saving heart valve replacements has steadily increased as life expectancy increases, detection of heart valve disease improves, and congenital heart disease patients survive into adulthood [1–4]. Mechanical valves, while durable, burden patients to lifelong anticoagulation which affect patient quality of life and represent a longitudinal
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