_edited.png)
Article by: Sharon Wong Shi May
Heart valve disease (HVD) is not a common cardiac condition. However, it remains a major cause of mortality and morbidity worldwide. According to CDC (2024), more than five million people in the US are diagnosed with HVD, resulting in approximately 25,000 deaths each year. Unfortunately, there is currently no effective medical treatment for HVD, leaving surgery and replacement of valves through a small incision as the only available options.
Currently, heart valves can be replaced with biological valves or mechanical valves. Biological valves (from cows, pigs, or human heart tissue) are susceptible to degradation and require frequent replacements. On the other hand, mechanical valves require patients to take blood-thinning drugs to avoid blood clotting. These limitations pose a challenge for infants born with congenital HVD as these valves do not grow with the patients, requiring frequent replacement before adulthood (Mayo Clinic, 2023).
Heart valves perform a variety of essential functions, including preventing the backflow of blood and ensuring one-way flow. Therefore, an ideal heart valve replacement should be capable of repairing, remodeling, and regenerating itself, ensuring the longevity and quality of life of the patients. Tissue engineering of a living heart valve with the necessary functions that grow with the patient offers a promising result.
Scaffolds (structural framework) are used to encourage in situ heart valve generation by utilizing the body’s natural repair mechanisms to create a living heart valve. Sir Magdi Yacoub’s team at Harefield and Imperial designed a heart valve known as the Heart Biotech Composite Component Valve (HCCV). This valve consists of a multi-layered, novel, jet-sprayed polycaprolactone (PCL) scaffold to stimulate in vivo valvulogenesis (valve formation). The scaffold is designed based on the 3D reconstruction of images of normal aortic roots, with a slight modification to enhance the fluid-to-solid interaction and improve coaptation (closing of the wounds). The scaffolds attract, house, and stimulate appropriate cells to grow a new valve. Over time, the scaffold will degenerate, leaving behind the body’s new valve (Yacoub et al., 2023).
Animal studies are being conducted over five years to assess the long-term regeneration capabilities of this technology. If successful, this treatment would offer a permanent and adaptable solution for patients of all ages with HVD. This breakthrough has the potential to revolutionize cardiovascular medicine, providing a long-term solution for HVD.
Citations:
CDC (2024). About Heart Valve Disease. [online] Heart Disease. Available at: https://www.cdc.gov/heart-disease/about/heart-valve-disease.html.
Mayo Clinic (2023). Heart Valve Surgery - Mayo Clinic. [online] Mayoclinic.org. Available at: https://www.mayoclinic.org/tests-procedures/heart-valve-surgery/about/pac-20384901.
Yacoub, M.H., Tseng, Y.-T., Kluin, J., Vis, A., Stock, U., Smail, H., Sarathchandra, P., Aikawa, E., El-Nashar, H., Chester, A.H., Shehata, N., Nagy, M., El-sawy, A., Li, W., Burriesci, G., Salmonsmith, J., Romeih, S. and Latif, N. (2023). Valvulogenesis of a living, Innervated Pulmonary Root Induced by an Acellular Scaffold. Communications Biology, 6(1017). doi:https://doi.org/10.1038/s42003-023-05383-z.
Opmerkingen