2003   Volume No 6 - pages 28-45

Title: Living artificial heart valve alternatives: a review

Authors: T.C. Flanagan and A Pandit

Address: National Centre for Biomedical Engineering Science, National University of Ireland, Galway, Galway, Ireland

E-mail: abhay.pandit@nuigalway.ie

Key Words: Heart valve, tissue engineering, cardiovascular system, extracellular matrix, heart valve prosthesis, interstitial cell, endocardial cell, biodegradable scaffold, bioreactor, growth factor.

Publication date: November 20th 2003

Abstract: Conventional replacement therapies for heart valve disease are associated with significant drawbacks. The field of tissue engineering has emerged as an exciting alternative in the search for improved heart valve replacement structures. One of the principles behind this concept is the transplantation of living elements, embedded in a suitable scaffold material, to the diseased site where the structure becomes integrated with patients' tissue to restore natural function. Significant progress has been made in the last ten years in the development of a living artificial heart valve alternative (LAHVA), with the identification of potential replacement sources for valve cells, scaffolds to maintain the cells in a three-dimensional environment, and signals to promote tissue development. This review addresses the need for a tissue-engineered alternative to current prostheses and provides a detailed account of normal heart valve structure - the blueprint for LAHVA fabrication. The research efforts to create a viable LAHVA, including recent developments, are discussed. Particular attention is focused on the choice of cell
source for LAHVA construction, the use of biodegradable natural and synthetic polymeric scaffolds as extracellular matrix derivatives, and exogenous stimulation of tissue growth. The critical challenges involved in LAHVA development and possible future areas of investigation are also discussed.

Article download: Pages 28-45. Special attachment to paper Table 4 (A3 size) (PDF file)