Research ArticleTissue Engineering

Computational modeling guides tissue-engineered heart valve design for long-term in vivo performance in a translational sheep model

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Science Translational Medicine  09 May 2018:
Vol. 10, Issue 440, eaan4587
DOI: 10.1126/scitranslmed.aan4587

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Modeling remodeling

Patients with valvular heart disease such as aortic stenosis (narrowing of the aortic valve in the heart) receive artificial or bioprosthetic valve replacements, but these have limited longevity and cannot grow with younger patients. Emmert et al. used computational modeling to design tissue-engineered heart valves from polymer scaffolds seeded with vascular cells. After 4 weeks of bioreactor culture, the grafts were decellularized before transcatheter implantation in sheep as pulmonary valve replacements. Nine of the 11 grafts remained functional up to 1 year later. Computational modeling predicted that valve leaflets would shorten in vivo during dynamic remodeling before reaching equilibrium, which was confirmed in the sheep. This work suggests that tissue engineering strategies should incorporate computational simulation to lead to more successful outcomes and more predictable clinical translation.