TexMi: development of tissue-engineered textile-reinforced mitral valve prosthesis

Area of Science:

• Biomaterials Engineering
• Cardiovascular Research
• Tissue Engineering

Background:

• Mitral valve regurgitation and aortic stenosis are prevalent valvular heart diseases.
• Current mechanical and biological prostheses have limitations including anticoagulation needs, calcification, and poor hemodynamic adaptation.
• Existing prostheses fail to replicate native valve annular-ventricular continuity, impacting durability and ventricular function.

Purpose of the Study:

• To develop a tissue-engineered heart valve specifically for the mitral position, addressing limitations of current substitutes.
• To create the TexMi valve, a living, textile-reinforced mitral valve mimicking native structure and function.
• To establish a proof-of-principle for a patient-specific, rapidly prototyped tissue-engineered mitral valve.

Main Methods:

• Development of the TexMi valve using a composite scaffold of fibrin gel and a textile tubular structure.
• Seeding the scaffold with ovine umbilical vein cells and dynamic stimulation in a custom bioreactor for 21 days.
• Utilizing a simple and reliable injection molding process with patient-specific rapid prototyped molds.

Main Results:

• Histological and immunohistological analyses confirmed significant tissue development, including aligned collagen and elastin deposition.
• The engineered tissue demonstrated no cell-mediated tissue contraction.
• Successful proof-of-concept for creating a tissue-engineered mitral valve adaptable to patient anatomy.

Conclusions:

• The TexMi valve represents a promising advancement in tissue-engineered heart valves for mitral valve replacement.
• The developed fabrication process allows for patient-specific valve creation, potentially improving hemodynamic performance and durability.
• This technology offers a potential solution to overcome the limitations of current prosthetic heart valves.