title: Decellularized xenogenic heart valves reveal remodeling and growth potential in vivo.
abstract: We have developed an advanced tissue processing technique on porcine pulmonary heart valves for pulmonary valve replacement and its initial clinical application during the autograft operation according to Ross. The novel concept consists of a cell-free matrix achieved by deoxycholic acid treatment that is repopulated by host cells in vivo. Molecular biology, radioligand binding, and electron microscopy consistently showed that these valves are almost free of cellular components. Animal experiments and clinical investigations revealed excellent hemodynamic properties of the valves, no need for antithrombotic therapy, and repopulation by host cells without any signs of calcification. In juvenile sheep the internal diameter of the implanted valves significantly increased in growing animals by approximately 10 mm. The repopulation of the decellularized heart valves was found not only in sheep but also in humans, which indicates that the underlying mechanisms, presumably repair mechanisms, might be common in mammals. If these findings can be confirmed by others, they will lead to new concepts in the field of cardiovascular tissue engineering that will eliminate the need for in vitro construction of autologous heart valves.
authors.affiliation: AutoTissue Ltd., Berlin, Germany. erdbruegger@autotissue.de
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Erdbrügger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Steffen
authors.initials: S
authors.lastname: Posner
authors.forename: Heinz
authors.initials: H
authors.lastname: Ellerbrok
authors.forename: Otto-Erich
authors.initials: OE
authors.lastname: Brodde
authors.forename: Horst
authors.initials: H
authors.lastname: Robenek
authors.forename: Diethelm
authors.initials: D
authors.lastname: Modersohn
authors.forename: Axel
authors.initials: A
authors.lastname: Pruss
authors.forename: Sebastian
authors.initials: S
authors.lastname: Holinski
authors.forename: Marita
authors.initials: M
authors.lastname: Stein-Konertz
authors.forename: Georg
authors.initials: G
authors.lastname: Pauli
mesh_terms: D000818:Animals; D003840:Deoxycholic Acid; D006351:Heart Valves / Q000502:physiology* / Q000637:transplantation; D012756:Sheep; D013552:Swine
chemical_list: D003840:Deoxycholic Acid