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Transcatheter aortic valve implantation using anatomically oriented, marrow stromal cell-based, stented, tissue-engineered heart valves: technical considerations and implications for translational cell-based heart valve concepts

Selected in European Journal of Cardio-Thoracic Surgery by Rylski

References

Authors

Maximilian Y. Emmert, Benedikt Weber, Luc Behr, Sebastien Sammut, Thomas Frauenfelder, Petra Wolint, Jacques Scherman, Dominique Bettex, Jürg Grünenfelder, Volkmar Falk and Simon P. Hoerstrupa

Reference

Eur J Cardiothorac Surg 2014;45:61-68

Published

January 2014

Link

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My Comment

Background

The currently used bioprosthesis for transcatheter aortic valve implantation (TAVI) are prone to continuous calcific degeneration. The authors sought to investigate the feasibility of autologous, cell-based, tissue-engineered heart valves combined with transapical implantation technology, applying the JenaValve transapical TAVI system.

Major findings

  • Heart valves were fabricated from biodegradable synthetic scaffolds sewn onto self-expanding Nitinol stents and seeded with autologous marrow stromal cells.
  • Heart valves were transapical delivered into the aortic valve position of 4 sheep.
  • The average time of cell harvest and valve implantation was 101 minutes.
  • There was no acute valve rupture. Central aortic regurgitation, most probably related to the leaflet design, was observed in 2 animals. There was no stent dislocation or migration and no coronary obstruction.

My comments

The authors are the first who successfully delivered an autologous, marrow stromal cell-based aortic valve using a state-of-the-art transapical delivery system. They made an important step towards tissue-engineered TAVI procedures, which, in the future, might broaden the indication for TAVI to younger population. This is an acute study on technical feasibility and further long-term follow-up data are necessary to evaluate the safety and efficacy of this novel interesting technology.

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