Tissue engineering vascular grafts a fortiori: looking back and going forward

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Cardiovascular Surgery

Background:

• Coronary heart disease and other cardiovascular conditions often require surgical repair with vascular grafts.
• Autografts are the current gold standard but have limitations, including harvesting difficulties and insufficient availability in patients with atherosclerosis.
• These limitations drive the need for alternative vascular graft sources.

Purpose of the Study:

• To review the current techniques and potential of tissue-engineered vascular grafts (TEVGs) as alternatives to traditional vascular grafts.
• To highlight the advantages and future prospects of TEVGs in cardiovascular medicine.

Main Methods:

• Overview of four primary TEVG production techniques: biodegradable synthetic scaffolds, gel-based scaffolds, decellularized scaffolds, and self-assembled cell-sheet-based methods.
• Categorization of the first three techniques as scaffold-guided approaches, utilizing a structural framework.
• Discussion of various cell sources for TEVGs, including somatic cells, stem cells, progenitor cells, and pluripotent stem cells.

Main Results:

• TEVGs offer significant advantages, including the ability to grow, remodel, and respond to environmental stimuli.
• Scaffold-guided approaches provide a supportive framework for vascular graft development.
• Diverse cell sources can be utilized for TEVG construction.

Conclusions:

• Tissue-engineered vascular grafts show immense potential, particularly with advancements in nanotechnology and tissue engineering.
• Refinements in decellularization techniques further enhance the prospects of TEVGs.
• TEVGs represent a significant future milestone for cardiovascular medicine upon clinical translation.