The relevance of large strains in functional tissue engineering of heart valves.
BACKGROUND
Exposing the developing tissue to flow and pressure in a bioreactor has been shown to enhance tissue formation in tissue-engineered heart valves. Animal studies showed excellent functionality in these valves in the pulmonary position. However, they lack the mechanical strength for implantation in the high-pressure aortic position. Improving the in vitro conditioning protocol is an important step towards the use of these valves as aortic heart valve replacements. In this study, the relevance of large strains to improve the mechanical conditioning protocol was investigated.


METHODS
Using a newly developed device, engineered heart valve tissue was exposed to increasing cyclic strain in vitro. Tissue formation and mechanical properties were analyzed and compared to unstrained controls.


RESULTS
Straining resulted in more pronounced and organized tissue formation with superior mechanical properties over unstrained controls. Overall tissue properties improved with increasing strain levels.


CONCLUSIONS
The results demonstrate the significance of large strains in promoting tissue formation. This study may provide a methodological basis for tissue engineering of heart valves appropriate for systemic pressure applications.
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.
A
A
Mol
C V C
CV
Bouten
G
G
Zünd
C I
CI
Günter
J F
JF
Visjager
M I
MI
Turina
F P T
FP
Baaijens
S P
SP
Hoerstrup
D020341:Absorbable Implants; D001698:Biomedical Engineering; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology; D020099:Coated Materials, Biocompatible / Q000494:pharmacology; D046508:Culture Techniques; D005109:Extracellular Matrix / Q000187:drug effects / Q000378:metabolism; D006025:Glycosaminoglycans / Q000378:metabolism; D006350:Heart Valve Prosthesis; D006801:Humans; D006885:Hydroxybutyrates / Q000494:pharmacology; D011100:Polyglycolic Acid / Q000494:pharmacology; D011474:Prosthesis Design; D013314:Stress, Mechanical; D023822:Tissue Engineering
D020099:Coated Materials, Biocompatible; D006025:Glycosaminoglycans; D006885:Hydroxybutyrates; D011100:Polyglycolic Acid