A Hybrid Tissue-Engineered Heart Valve

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A Hybrid Tissue-Engineered Heart Valve S. Hamed Alavi, PhD, Arash Kheradvar, MD, PhD The Annals of Thoracic Surgery Volume 99, Issue 6, Pages 2183-2187 (June 2015) DOI: 10.1016/j.athoracsur.2015.02.058 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Nitinol scaffold fabricated for growing trileaflet hybrid heart valves. (A) Flat Nitinol mesh cut to the desired shape of a leaflet. (B) Trileaflet hybrid valve scaffold made of Nitinol mesh leaflets. The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Custom-made bioreactor developed to dynamically condition the leaflet tissues. (A) Experimental setup consists of a peristaltic pump system, tubular container, compliance chamber, and tubing system. (B) Hybrid leaflet samples assembled in the container system and exposed to the experimental flow rates. (C) Schematic representation of bioreactor setup. The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Hybrid heart valve at various stages of development. Nitinol structure along with (A) smooth muscle, (B) fibroblast/myofibroblast, and (C) endothelial cells, all encapsulated in collagen as the first, second, and third layers, respectively. The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Quantitative biochemical assays performed on the statically and dynamically conditioned hybrid valves, showing increase in DNA content and matrix protein values for dynamic groups versus static groups. (GAG = glycosaminoglycan.) The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Qualitative histologic assays performed on the statically and dynamically conditioned groups. H&E stain representing a spongy structure for (A) static group versus (B) dense composition for dynamically conditioned leaflets. (C) Stimulated raman scattering staining shows that the mesh is completely enclosed within the tissue. (D) Light Green staining demonstrates a fibrous structure with a uniform cellularity throughout the leaflets. The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Testing the valve performance inside a heart flow simulator. (A) Function of the porous Nitinol scaffold under the flow rate of 5 L/min. (B) Left ventricle sac of the heart pulsed flow simulator filled with basal media. (C) Function of hybrid valves under 2.5 L/min showing comparable performance with native valves. The Annals of Thoracic Surgery 2015 99, 2183-2187DOI: (10.1016/j.athoracsur.2015.02.058) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions