In Situ Remodeling Overrules Bioinspired Scaffold Architecture of Supramolecular Elastomeric Tissue-Engineered Heart Valves
Marcelle Uiterwijk, Anthal I.P.M. Smits, Daphne van Geemen, Bas van Klarenbosch, Sylvia Dekker, Maarten J. Cramer, Jan Willem van Rijswijk, Emily B. Lurier, Andrea Di Luca, Marieke Brugmans, Tristan Mes, Anton W. Bosman, Elena Aïkawa, Paul F. Gründeman, Carlijn V. C. Bouten, Jolanda Kluin
Abstract
In situ tissue engineering that uses resorbable synthetic heart valve scaffolds is an affordable and practical approach for heart valve replacement; therefore, it is attractive for clinical use. This study showed no consistent collagen organization in the predefined direction of electrospun scaffolds made from a resorbable supramolecular elastomer with random or circumferentially aligned fibers, after 12 months of implantation in sheep. These unexpected findings and the observed intervalvular variability highlight the need for a mechanistic understanding of the long-term in situ remodeling processes in large animal models to improve predictability of outcome toward robust and safe clinical application.