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Eur J Cardiothorac Surg 1999;14:279-284
© 1999 Elsevier Science NL
a Leibniz Research Laboratories for Biotechnology and Artificial Organs, Division of Thoracic and Cardiovascular Surgery, LEBAO, Hannover Medical School, Podbielskistrasse 380, D-30659 Hannover, Germany
b Department of Cell Biology and Electron Microscopy, Hannover Medical School, Hannover, Germany
Received 8 December 1997; received in revised form 7 May 1998; accepted 26 May 1998.
Corresponding author. Tel.: +49 511 906 3510; fax: +49 511 906 3569; e-mail: abader@artificial-organs.de
Objective: Tissue engineering of heart valves represents a new experimental concept to improve current modes of therapy in valvular heart disease. Drawbacks of glutaraldehyde fixed tissue valves or mechanical valves include the short durability or the need for life-long anticoagulation, respectively. Both have in common the inability to grow, which makes valvular heart disease especially problematic in children. The aim of this study was to develop a new methodology for a tissue engineered heart valve combining human cells and a xenogenic acellularized matrix. Methods: Porcine aortic valves were acellularized by deterging cell extraction using Triton® without tanning. Endothelial cells were isolated in parallel from human saphenous veins and expanded in vitro. Specimens of the surface of the acellular matrix were seeded with endothelial cells. Analysis of acellularity was performed by light microscopy and scanning electron microscopy. Cell viability following seeding was assayed by fluorescence staining of viable cells. Results: The acellularization procedure resulted in an almost complete removal of the original cells while the 3D matrix was loosened at interfibrillar zones. However the 3D arrangement of the matrix fibers was grossly maintained. The porcine matrix could be seeded with in vitro expanded human endothelial cells and was maintained in culture for up to 3 days to document the formation of confluent cultures. Conclusions: Porcine aortic valves can be almost completely acellularized by a non-tanning detergent extraction procedure. The xenogenic matrix was reseeded with human endothelial cells. This approach may eventually lead to the engineering of tissue heart valves repopulated with the patients own autologous cells.
Key Words: Extracellular matrix • Tissue engineering • Valvular heart disease
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