title: Tissue-Engineered Fibrin-Based Heart Valve with Bio-Inspired Textile Reinforcement.
abstract: The mechanical properties of tissue-engineered heart valves still need to be improved to enable their implantation in the systemic circulation. The aim of this study is to develop a tissue-engineered valve for the aortic position - the BioTexValve - by exploiting a bio-inspired composite textile scaffold to confer native-like mechanical strength and anisotropy to the leaflets. This is achieved by multifilament fibers arranged similarly to the collagen bundles in the native aortic leaflet, fixed by a thin electrospun layer directly deposited on the pattern. The textile-based leaflets are positioned into a 3D mould where the components to form a fibrin gel containing human vascular smooth muscle cells are introduced. Upon fibrin polymerization, a complete valve is obtained. After 21 d of maturation by static and dynamic stimulation in a custom-made bioreactor, the valve shows excellent functionality under aortic pressure and flow conditions, as demonstrated by hydrodynamic tests performed according to ISO standards in a mock circulation system. The leaflets possess remarkable burst strength (1086 mmHg) while remaining pliable; pronounced extracellular matrix production is revealed by immunohistochemistry and biochemical assay. This study demonstrates the potential of bio-inspired textile-reinforcement for the fabrication of functional tissue-engineered heart valves for the aortic position.
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Moreira
authors.affiliation: Institute for Textile Engineering, RWTH Aachen University, Otto-Blumenthal-Str. 1, 52074, Aachen, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Neusser
authors.affiliation: Institute for Textile Engineering, RWTH Aachen University, Otto-Blumenthal-Str. 1, 52074, Aachen, Germany.
authors.forename: Magnus
authors.initials: M
authors.lastname: Kruse
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Shane
authors.initials: S
authors.lastname: Mulderrig
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Frederic
authors.initials: F
authors.lastname: Wolf
authors.affiliation: Department for Cardiothoracic- and Vascular Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Spillner
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz-Rode
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.|Institute for Textile Engineering, RWTH Aachen University, Otto-Blumenthal-Str. 1, 52074, Aachen, Germany.|Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Jockenhoevel
authors.affiliation: Department of Tissue Engineering and Textile Implant, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.|Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Mela
mesh_terms: D001705:Bioprosthesis; D002478:Cells, Cultured; D005337:Fibrin / Q000737:chemistry*; D006350:Heart Valve Prosthesis; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000378:metabolism*; D032389:Myocytes, Smooth Muscle / Q000378:metabolism*; D013784:Textiles; D023822:Tissue Engineering / Q000379:methods*
chemical_list: D005337:Fibrin
keywords: aortic valve; hydrodynamic performance; replacement; textile reinforcement; tissue-engineering