FABRICATION OF VASCULAR GRAFTS AND EFFECTS OF DESIGN PARAMETERS ON ARTERIAL REMODELING and DEVELOPMENT OF TISSUE ENGINEERED HEART VALVE FOR PERCUTANEOUS TRANSCATHETER DELIVERY
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The growing incidence of ischemic heart disease and limitation of autologous grafts propel the development of tissue-engineered vascular grafts for bypass applications. Significant advancements were achieved with studies of grafts varying in materials, structures, and surface modification. However, widely diverse design parameters of vascular grafts hinder researchers and clinicians coming to a consensus of an optimized design. The effects of scaffold material and structural designs on remodeling outcomes remain the focus of vascular grafts development. Previous studies reported that degradable poly(glycerol sebacate) (PGS)/polycaprolactone (PCL) hybrid graft remodeled into arterial tissue structures and showed translational potential. Based on this bilayered design, the effects of wall thickness ratio on arterial remodeling were investigated. Performances of two TEVGs differed in core thickness were evaluated using a murine model. Temporal change and design-based differences in tissue contents and mechanical behavior were observed through 24 weeks. Correlating with computational simulations, the results suggest increasing the wall stress of the vascular graft toward native values by increasing wall thickness ratio provides an environment favors formation of arterial constituents. Conventional fabrication methods of vascular grafts fall short to provide precise multiparametric control of structures. Computer-aided design and 3D printing have shown potential to overcome this challenge. Utilizing photocurable PGS, ink formulations varying diluents, prepolymer concentration, and degree of acrylation were studied to optimize printing efficiency and bulk properties of the printed scaffolds. Post-fabrication treatments of photocrosslinked scaffolds demonstrated tunability in degradation and mechanical properties. Porous tubular scaffolds printed with this platform present high mimicry to complex 3D models, realizing multiparametric control of TEVG designs. In situ tissue engineering utilizes host tissue to remodel biodegradable vascular grafts into living neoarteries. Similarly, the regenerative capacity of fetal milieu is of great potential in remodeling scaffolds into neovalves with the ability to grow. A fully degradable valve made of electrospun PCL leaflets and zinc-aluminum alloy stent was analyzed and delivered percutaneously in a fetal ovine model. Echocardiogram showed no stenosis and regurgitation after valve implantation. The fetus matured and was delivered at term. This pilot study demonstrates the potential of transcatheter valve replacement in utero for treating congenital cardiac anomalies.
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Shepherd, Robert F.