Advancements and Challenges in Tissue-Engineered Heart Valves: Integrating Biomechanics, Biomaterials, and Biomimetic...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Cardiovascular Engineering

Background:

• Valvular heart disease poses a significant global health challenge.
• Current prosthetic heart valves lack the adaptive and regenerative capabilities of native valves.
• Tissue-engineered heart valves (TEHVs) show promise but face clinical translation hurdles.

Purpose of the Study:

• To review recent advances in TEHV development from a biomimetic perspective.
• To integrate valve biology, mechanobiology, and engineering strategies for TEHV maturation.
• To define principles for developing durable, regenerative, and clinically translatable TEHVs.

Main Methods:

• Biomimetic design principles inspired by native heart valve structure and function.
• Integration of scaffold materials, architecture, and bioactive functionalization.
• Application of biomechanical conditioning using dynamic bioreactor systems.

Main Results:

• Biomimetic scaffolds replicate native extracellular matrix organization and mechanics.
• Biological cues modulate thrombosis, immune response, and cell recruitment.
• Dynamic bioreactors promote functional tissue maturation via mechanical stimulation.

Conclusions:

• Successful TEHV translation requires synchronized control of scaffold anisotropy, immune modulation, and mechanical conditioning.
• Biomimetically informed design is crucial for overcoming current limitations.
• Integrated approaches are needed to accelerate the development of next-generation heart valves.