A geometrically adaptable heart valve replacement.
Sophie C HofferberthMossab Y SaeedLara TomholtMatheus C FernandesChristopher J PayneKarl PriceGerald R MarxJesse J EschDavid W BrownJonathan BrownPeter E HammerRichard W BiancoJames C WeaverElazer R EdelmanPedro J Del NidoPublished in: Science translational medicine (2021)
Congenital heart valve disease has life-threatening consequences that warrant early valve replacement; however, the development of a growth-accommodating prosthetic valve has remained elusive. Thousands of children continue to face multiple high-risk open-heart operations to replace valves that they have outgrown. Here, we demonstrate a biomimetic prosthetic valve that is geometrically adaptable to accommodate somatic growth and structural asymmetries within the heart. Inspired by the human venous valve, whose geometry is optimized to preserve functionality across a wide range of constantly varying volume loads and diameters, our balloon-expandable synthetic bileaflet valve analog exhibits similar adaptability to dimensional and shape changes. Benchtop and acute in vivo experiments validated design functionality, and in vivo survival studies in growing sheep demonstrated that mechanical valve expansion accommodated growth. As illustrated in this work, dynamic size adaptability with preservation of unidirectional flow in prosthetic valves thus offers a paradigm shift in the treatment of heart valve disease.
Keyphrases
- aortic valve
- mitral valve
- aortic stenosis
- transcatheter aortic valve replacement
- aortic valve replacement
- transcatheter aortic valve implantation
- left ventricular
- atrial fibrillation
- gene expression
- endothelial cells
- hepatitis b virus
- coronary artery disease
- liver failure
- genome wide
- dna methylation
- intensive care unit
- copy number
- extracorporeal membrane oxygenation
- replacement therapy
- induced pluripotent stem cells