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
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
Eur J Cardiothorac Surg 2014;45:61-68
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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.
- 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.
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.