Tissue engineered heart valves for transcatheter aortic valve implantation: current state, challenges, and future...

Area of Science:

• Cardiovascular Research
• Biomaterials Science
• Regenerative Medicine

Background:

• Transcatheter aortic valve implantation (TAVI) has transformed severe aortic stenosis treatment, but valve durability is critical for low-risk patients.
• Current TAVI bioprostheses, derived from xenogeneic materials, are prone to degeneration, necessitating re-interventions.
• Tissue engineered heart valves (TEHVs) are emerging as a potential solution for durable, long-term TAVI replacements.

Purpose of the Study:

• To explore the potential of tissue engineered heart valves (TEHVs) as a durable replacement for transcatheter aortic valve implantation (TAVI).
• To summarize the advancements and challenges in developing transcatheter TEHVs for TAVI applications.
• To highlight TEHVs as a next-generation technology for lifelong TAVI prostheses.

Main Methods:

• Review of current advancements in TAVI prostheses design and development.
• Evaluation of the potential of TEHVs, focusing on their regenerative capacities like remodeling, self-repair, and growth.
• Assessment of demonstrated performance and remodeling of transcatheter TEHVs in preclinical settings.

Main Results:

• Transcatheter TEHVs demonstrate potential to overcome the degeneration issues associated with current TAVI bioprostheses.
• In-situ regenerative potential, including remodeling and acute performance, has been shown in preclinical models.
• Significant challenges remain for the safe clinical translation of TEHVs for TAVI.

Conclusions:

• Long-term valve durability is paramount for TAVI, especially in younger and low-risk populations.
• TEHVs, with proven long-term performance and remodeling capabilities, represent a promising next-generation technology for TAVI.
• Successful clinical translation of TEHVs could significantly reduce re-interventions and improve patient quality of life.