title: A Pulsatile Bioreactor for Conditioning of Tissue-Engineered Cardiovascular Constructs under Endoscopic Visualization.
abstract: Heart valve disease (HVD) is a globally increasing problem and accounts for thousands of deaths yearly. Currently end-stage HVD can only be treated by total valve replacement, however with major drawbacks. To overcome the limitations of conventional substitutes, a new clinical approach based on cell colonization of artificially manufactured heart valves has been developed. Even though this attempt seems promising, a confluent and stable cell layer has not yet been achieved due to the high stresses present in this area of the human heart. This study describes a bioreactor with a new approach to cell conditioning of tissue engineered heart valves. The bioreactor provides a low pulsatile flow that grants the correct opening and closing of the valve without high shear stresses. The flow rate can be regulated allowing a steady and sensitive conditioning process. Furthermore, the correct functioning of the valve can be monitored by endoscope surveillance in real-time. The tubeless and modular design allows an accurate, simple and faultless assembly of the reactor in a laminar flow chamber. It can be concluded that the bioreactor provides a strong tool for dynamic pre-conditioning and monitoring of colonized heart valve prostheses physiologically exposed to shear stress.
authors: Chair of Medical Engineering, Technical University Munich, Boltzmannstrasse 15, Garching 85748, Germany. f.koenig@mytum.de.
authors: Fabian
authors: F
authors: König
authors: Department of Cardiac Surgery, Medical Center Munich University, Marchioninistr. 15, Munich 81377, Germany. Trixi.Hollweck@med.uni-muenchen.de.
authors: Trixi
authors: T
authors: Hollweck
authors: Chair of Medical Engineering, Technical University Munich, Boltzmannstrasse 15, Garching 85748, Germany. stefan.pfeifer@tum.de.
authors: Stefan
authors: S
authors: Pfeifer
authors: Department of Cardiac Surgery, Medical Center Munich University, Marchioninistr. 15, Munich 81377, Germany. Bruno.Reichart@med.uni-muenchen.de.
authors: Bruno
authors: B
authors: Reichart
authors: Chair of Medical Engineering, Technical University Munich, Boltzmannstrasse 15, Garching 85748, Germany. wintermantel@tum.de.
authors: Erich
authors: E
authors: Wintermantel
authors: Department of Cardiac Surgery, Medical Center Munich University, Marchioninistr. 15, Munich 81377, Germany. Christian.Hagl@med.uni-muenchen.de.
authors: Christian
authors: C
authors: Hagl
authors: Department of Cardiac Surgery, Medical Center Munich University, Marchioninistr. 15, Munich 81377, Germany. bassil.akra@med.uni-muenchen.de.
authors: Bassil
authors: B
authors: Akra