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Published on: June 8, 2022
Pulmonary Valve Replacement: A New Paradigm with Tissue Engineering
Rúben Almeida-Pinto1, Adelino F Leite-Moreira1, Carmen Brás-Silva2
1UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
Insights
Congenital heart defects affecting the pulmonary valve require better long-term solutions. Tissue engineering offers promising living valves to overcome limitations of current mechanical and bioprosthetic options.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Regenerative Medicine
Background:
- Congenital heart diseases (CHDs) affect 9 per 1000 newborns globally, with 20% impacting the pulmonary valve or right ventricular outflow tract.
- Improved surgical repair survival necessitates addressing long-term issues in patients with repaired CHDs.
- Current mechanical and bioprosthetic valves have limitations, including inability to grow and adapt hemodynamically, impacting long-term patient quality of life.
Purpose of the Study:
- To review the performance of traditional pulmonary valves used in CHD repair.
- To explore the potential of tissue engineering-based living valves for improved patient management.
- To address the unmet needs in long-term care for individuals with repaired pulmonary valve defects.
Main Methods:
- Literature review of traditional pulmonary valve replacements (mechanical and bioprosthetic).
- Analysis of limitations associated with current prosthetic valve technologies.
- Exploration of tissue engineering strategies for developing living pulmonary valves.
Main Results:
- Traditional valves offer improved survival but present suboptimal long-term outcomes due to growth and adaptation limitations.
- Tissue engineering approaches are being investigated to create living valves that can potentially overcome these limitations.
- The development of regenerative pulmonary valves is a key area of research for addressing long-term CHD management.
Conclusions:
- There is a critical need for advanced pulmonary valve solutions beyond current prosthetic options.
- Tissue engineering holds significant promise for developing living valves that can grow and adapt, improving long-term outcomes for CHD patients.
- Further research into regenerative pulmonary valves is essential for enhancing the quality of life for individuals with congenital heart conditions.
Abstract:
Prevalence of congenital heart diseases worldwide is around 9 per 1000 newborns, 20% of which affect the pulmonary valve or right ventricular outflow tract. As survival after surgical repair of these defects has improved over time, there is the need to address the long-term issues of older children and young adults with "repaired" congenital heart diseases. In recent decades, the most used types of valves are the mechanical and bioprosthetic valves. Despite improving patients' quality of life, these effects are suboptimal due to their limitations, such as the inability to grow and adapt to hemodynamic changes. These issues have led to the search for living valve solutions through tissue engineering to respond to these challenges. This article aims to review the performance of traditional pulmonary valves and understand how tissue engineering-based valves can improve the management of these patients.
