TY - JOUR
T1 - Mid-term function and remodeling potential of tissue engineered tricuspid valve
T2 - Histology and biomechanics
AU - Ropcke, Diana M
AU - Rasmussen, Jonas
AU - Ilkjær, Christine
AU - Skov, Søren N
AU - Tjørnild, Marcell J
AU - Baandrup, Ulrik T
AU - Christian Danielsen, Carl
AU - Hjortdal, Vibeke E
AU - Nielsen, Sten L
N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Objective: Tricuspid valve reconstruction using a small intestinal submucosal porcine extracellular matrix (ECM) tube graft is hypothesized to be durable for six months and show signs of recellularization and growth potential. The purpose was to histologically and biomechanically test ECM valves before and after six months of implantation in pigs for comparison with native valves. Methods: Ten 60 kg pigs were included, which survived tricuspid valve tube graft insertion. Anterior and septal tricuspid leaflets were explanted from all animals surviving more than one month and examined histologically (n = 9). Endothelialization, collagen content, mineralization, neovascularization, burst strength and tensile strength were determined for native valves (n = 5), ECM before implantation (n = 5), and ECM after six months (n = 5). Results: Collagen density was significantly larger in ECM at implantation (baseline) compared to native leaflet tissue (0.3 ± 0.02 mg/mm
3 vs. 0.1 ± 0.03 mg/mm
3 , p <.0001), but collagen density decreased and reached native leaflet collagen content, six months after ECM implantation (native vs. ECM valve at six months: 0.1 ± 0.03 mg/mm
3 vs. 0.2 ± 0.05 mg/mm
3 , p =.8). Histologically, ECM valves showed endothelialization, host cell infiltration and structural collagen organization together with elastin generation after six months, indicating tissue remodeling and -engineering together with gradual development of a close-to-native leaflet structure without foreign body response. Conclusions: ECM tricuspid tube grafts were stronger than native leaflet tissue. Histologically, the acellular ECM tube grafts showed evidence of constructive tissue remodeling with endothelialization and connective tissue organization. These findings support the concept of tissue engineering and recellularization, which are prerequisites for growth.
AB - Objective: Tricuspid valve reconstruction using a small intestinal submucosal porcine extracellular matrix (ECM) tube graft is hypothesized to be durable for six months and show signs of recellularization and growth potential. The purpose was to histologically and biomechanically test ECM valves before and after six months of implantation in pigs for comparison with native valves. Methods: Ten 60 kg pigs were included, which survived tricuspid valve tube graft insertion. Anterior and septal tricuspid leaflets were explanted from all animals surviving more than one month and examined histologically (n = 9). Endothelialization, collagen content, mineralization, neovascularization, burst strength and tensile strength were determined for native valves (n = 5), ECM before implantation (n = 5), and ECM after six months (n = 5). Results: Collagen density was significantly larger in ECM at implantation (baseline) compared to native leaflet tissue (0.3 ± 0.02 mg/mm
3 vs. 0.1 ± 0.03 mg/mm
3 , p <.0001), but collagen density decreased and reached native leaflet collagen content, six months after ECM implantation (native vs. ECM valve at six months: 0.1 ± 0.03 mg/mm
3 vs. 0.2 ± 0.05 mg/mm
3 , p =.8). Histologically, ECM valves showed endothelialization, host cell infiltration and structural collagen organization together with elastin generation after six months, indicating tissue remodeling and -engineering together with gradual development of a close-to-native leaflet structure without foreign body response. Conclusions: ECM tricuspid tube grafts were stronger than native leaflet tissue. Histologically, the acellular ECM tube grafts showed evidence of constructive tissue remodeling with endothelialization and connective tissue organization. These findings support the concept of tissue engineering and recellularization, which are prerequisites for growth.
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=85044501626&partnerID=8YFLogxK
U2 - 10.1016/j.jbiomech.2018.01.019
DO - 10.1016/j.jbiomech.2018.01.019
M3 - Journal article
C2 - 29428174
SN - 0021-9290
VL - 71
SP - 52
EP - 58
JO - Journal of Biomechanics
JF - Journal of Biomechanics
ER -