Valvulogenesis of a living, innervated pulmonary root induced by an acellular scaffold
Magdi H. Yacoub, Yuan‐Tsan Tseng, Jolanda Kluin, Annemijn Vis, Ulrich A. Stock, Hassiba Smail, Padmini Sarathchandra, Elena Aïkawa, Hussam El-Nashar, Adrian H. Chester, Nairouz Shehata, Mohamed Nagy, Amr El-sawy, Wei Li, Gaetano Burriesci, Jacob Salmonsmith, Soha Romeih, Najma Latif
Abstract
Heart valve disease is a major cause of mortality and morbidity worldwide with no effective medical therapy and no ideal valve substitute emulating the extremely sophisticated functions of a living heart valve. These functions influence survival and quality of life. This has stimulated extensive attempts at tissue engineering "living" heart valves. These attempts utilised combinations of allogeneic/ autologous cells and biological scaffolds with practical, regulatory, and ethical issues. In situ regeneration depends on scaffolds that attract, house and instruct cells and promote connective tissue formation. We describe a surgical, tissue-engineered, anatomically precise, novel off-the-shelf, acellular, synthetic scaffold inducing a rapid process of morphogenesis involving relevant cell types, extracellular matrix, regulatory elements including nerves and humoral components. This process relies on specific material characteristics, design and "morphodynamism".