Supplementary Materials

Supplementary Material for:

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

Maximilian Y. Emmert, Boris A. Schmitt, Sandra Loerakker, Bart Sanders, Hendrik Spriestersbach, Emanuela S. Fioretta, Leon Bruder, Kerstin Brakmann, Sarah E. Motta, Valentina Lintas, Petra E. Dijkman, Laura Frese, Felix Berger, Frank P. T. Baaijens, Simon P. Hoerstrup*

*Corresponding author. Email: simon.hoerstrup{at}

Published 9 May 2018, Sci. Transl. Med. 10, eaan4587 (2018)
DOI: 10.1126/scitranslmed.aan4587

This PDF file includes:

  • Materials and Methods
  • Fig. S1. Schematic overview of study concept.
  • Fig. S2. Gross and histological characterization of a control TEHV.
  • Fig. S3. Overview of the clinical-grade percutaneous implantation system and the multimodality imaging protocols to assess TEHV positioning, functionality, and performance throughout the study.
  • Fig. S4. Computational predictions of valve remodeling and postmortem analysis of valve G, which was malpositioned upon implantation.
  • Fig. S5. Longitudinal cardiac MRI flow measurements for the assessment of TEHV function and regurgitation fraction over 1 year.
  • Fig. S6. Postmortem analyses of valve E explanted after 6 months in vivo.
  • Fig. S7. Additional results on the computational predictions of in vivo strains and valve remodeling based on initial tissue properties.
  • Fig. S8. Analysis of collagen alignment.
  • Fig. S9. Histological evaluation of cellular infiltration in a representative valve (valve N) using Masson Goldner staining.
  • Fig. S10. Evaluation of elastogenesis and neosinus formation.
  • Fig. S11. Assessment of leaflet length and position.
  • Fig. S12. Evaluation of calcification in different explants with von Kossa staining.
  • Fig. S13. Histological evaluation of the inflammatory response using H&E staining.
  • Fig. S14. Evaluation of leaflet remodeling using Elastica van Gieson staining.
  • Fig. S15. Postmortem analyses of valve J explanted after 1 year in vivo.
  • Fig. S16. Immunohistochemical analysis for presence and distribution of αSMA-positive cells in valve G.
  • Fig. S17. Schematic representation depicting the functional remodeling process within the TEHV.
  • Table S1. In vitro TEHV functionality before implantation.
  • Table S2. Animal characteristics.
  • Table S3. Pulmonary dimensions and hemodynamics before and after implantation.
  • Table S4. Functional long-term catheter data (invasive hemodynamic measurements) of TEHVs at baseline and after 1 year.
  • Table S5. Functional ICE data of TEHVs at baseline and after 1 year.
  • Table S6. Functional MRI data of TEHV insufficiency at baseline and after 1 year.
  • Table S7. Leaflet thickness in the explants.
  • References (5052)

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Other Supplementary Material for this manuscript includes the following:

  • Movie S1 (.mp4 format). In vitro TEHV testing.
  • Movie S2 (.avi format). Angiography after TEHV implantation.
  • Movie S3 (.avi format). ICE after implantation.
  • Movie S4 (.avi format). Color-coded ICE after implantation.
  • Movie S5 (.avi format). ICE at 6-month follow-up.
  • Movie S6 (.avi format). Color-coded ICE at 6-month follow-up.
  • Movie S7 (.avi format). ICE at 12-month follow-up.
  • Movie S8 (.avi format). Color-coded ICE at 12-month follow-up.