ISACB Forum - Heart Valve Biology and Tissue Engineering - the Challenge
Tissue engineering requires a multi-disciplinary approach and presents a diversity of challenges to biologists, engineers, material scientists, clinicians and regulators. This is especially true for engineering heart valve and cardiac tissue. The engineering of a heart valve that is able to function as the native valve and remain viable for the life of the recipient is the long-term goal of many research groups worldwide. In order to achieve this, a number of integral steps must be completed. These include establishing an appropriate choice of cells that will mimic the function of the native valve cells, identification of a suitable scaffold material on which to seed the cells and determination of optimal mechanical conditioning protocols, to promote the development of a fully-functioning tissue engineered valve. Importantly, the tissue engineered valve must function optimally in a highly dynamic, high flow/pressure environment immediately it is implanted.
Although both mechanical and tissue valves have improved in performance over the years, they continue to have limitations and lack the sophisticated function of the native valve. It is anticipated that a viable tissue engineered valve would not possess the disadvantages of currently available valve replacements, many of which are due to the absence of viable cells. In addition, a tissue engineered valve would provide an inexhaustible source of replacement valves able to cope with the predicted tripling prevalence of valve disease over the next 50 years.
Some headway towards these goals is being made by a number of research groups. A compilation of articles addressing the multi-disciplinary nature of tissue engineering valve and cardiac tissues can be found in the August issue of the Philosophical Transactions of the Royal Society Series B: Biological Sciences edited by Professors Magdi Yacoub and Robert Nerem. It is hoped that this issue of the Philosophical Transactions will serve to accelerate progress in this important field.
Adrian Chester, Patricia Taylor and Magdi Yacoub, Harefield Heart Science Centre, Imperial College London
