Abstract:
Background: Heart valve disease is a clinically serious condition. The replacement of damaged valves practiced since the 1950’s is the ultimate treatment
for end-stage heart failure caused by severe valve dysfunction. The choice of adequate prosthesis is challenging. Unfortunately, the treatment options
available today do not satisfy completely physicians and scientists’ needs. Mechanical valves require long-term anticoagulation therapy because of poor
hemocompatibility. Biological substitutes have better hemodynamics, but need replacement in ~ 10 years due to calcification and degeneration. In order
to overcome the shortcomings of current treatment options many researches are motivated to fabricate a functional, living heart valve replacement by
tissue engineering.
Conclusions: Tissue engineering is a promising approach that may lead novel constructs that will satisfy the need and overcome the limitations of current
valve prosthetics. Scaffolds, fabricated from synthetic or biological materials, do not require donor tissue, but have struggled to recreate the macro- and
micro valve anatomy and mechanical properties of native valve. Decellularized cardiovascular grafts have the opportunity to improve patients care by
reducing the risk of sensitization to donor antigens, calcify and stenosis and providing with a good graft that will grow (especially important in children).
In this way the emotional and financial drain on the patient and family of enduring multiple surgeries may be significantly minimized. The choice of
decellularization method can be rational if mechanism of action is contemplated and clearly understood.
Description:
Laboratory of Tissue Engineering and Cell Cultures, Department of Topographic Anatomy and Operative Surgery, Department of Surgery No 4, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova