Differential Leaflet Remodeling of Bone Marrow Cell Pre-Seeded Versus Nonseeded Bioresorbable Transcatheter Pulmonary Valve Replacements

Fioretta, Emanuela S., Lintas, Valentina, Mallone, Anna, Motta, Sarah E., von Boehmer, Lisa, Dijkman, Petra E., Cesarovic, Nikola, Caliskan, Etem, Rodriguez Cetina Biefer, Héctor, Lipiski, Miriam, Sauer, Mareike, Putti, Matilde, Janssen, Henk M., Söntjens, Serge H., Smits, Anthal I.P.M., Bouten, Carlijn V.C., Emmert, Maximilian Y. & Hoerstrup, Simon P.

Published: 01/01/2020


This study showed that bone marrow mononuclear cell pre-seeding had detrimental effects on functionality and in situ remodeling of bioresorbable bisurea-modified polycarbonate (PC-BU)-based tissue-engineered heart valves (TEHVs) used as transcatheter pulmonary valve replacement in sheep. We also showed heterogeneous valve and leaflet remodeling, which affects PC-BU TEHV safety, challenging their potential for clinical translation. We suggest that bone marrow mononuclear cell pre-seeding should not be used in combination with PC-BU TEHVs. A better understanding of cell–scaffold interaction and in situ remodeling processes is needed to improve transcatheter valve design and polymer absorption rates for a safe and clinically relevant translation of this approach.

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