- Pediatric Heart Valve
Congenital heart defects such as aortic valve stenosis and ventricular outflow tract dysfunctions often require heart valve replacements in pediatric patients. Currently, standard of care for pediatric valve replacement is mechanical prosthesis and smaller sized adult tissue prosthesis which requires lifelong anticoagulation and risks limited longevity due to increasing patient-prosthesis mismatch. The only expandable valve prostheses for accommodating growth are off-label products that were not designed for pediatric patients, and therefore, they are not available in sizes less than 19mm. Common complications involving off-label pediatric valves include valve dislodgement, stent fracturing, recurrent stenosis, and regurgitation. A critical need exists for a safe, durable, and cost-effective pediatric valve.
The objective of this study is to develop a pediatric heart valve and also develop a testing methodology to investigate the function of the valve with respect to patient growth.
- Fetal Heart Valve
Congenital cardiac anomalies represent the most common birth defect, affecting approximately 0.9% of all live births. Most major congenital cardiac anomalies require reconstructive surgery, often requiring the use of man-made, xenographic, or homograft material in the form bioprosthetic heart valves and valved conduits. Tissue engineering provides a potential strategy for creating better biomaterials for use in reconstructive cardiac operations. Using tissue engineering techniques, replacement heart valves can be made from a biodegradable scaffold and an individual’s own cells. Over time, the resulting autologous neovalves become living structures with the ability to grow, repair, and remodel. The regenerative capacity of the fetal milieu makes it a prime target for tissue regeneration and neovalve formation. This unique environment was the impetus for the development of fetal cardiac interventions.
This goal of this study is to develop a fully biodegradable tissue-engineered heart valve (TEHV), and the feasibility of replacing the fetal pulmonary valve with a percutaneous, transcatheter, which was studied in vitro through accelerated degradation, mechanical, and hemodynamic testing and in vivo by implantation into a fetal lamb.
Selected Publications
- Bhat SS, Bui HT, Farnan A, Vietmeyer K, Armstrong AK, Breuer CK, Dasi LP. Development of Novel Sutureless Balloon Expandable Fetal Heart Valve Device Using Absorbable Polycaprolactone Leaflets. Ann Biomed Eng. 2023 Oct 20. doi: 10.1007/s10439-023-03386-9. Epub ahead of print. PMID: 37864043.
- Hatoum H, Gooden S, Heitkemper M, Blum K M, Zakko J, Bocks M, Yi T, Wu Y-L, Wang Y, Breuer CK and Dasi LP. Fetal Transcatheter Trileaflet Heart Valve Hemodynamics: Implications of Scaling on Valve Mechanics and Turbulence. Ann Biomed Eng. 2020. doi:10.1007/s10439-020-02475-3
- Zakko, J., Blum, K. M., Drews, J. D., Wu, Y. L., Hatoum, H., Russell, M., Gooden, S., Heitkemper, M., Conroy, O., Kelly, J., Carey, S., Sacks, M., Texter, K., Ragsdale, E., Strainic, J., Bocks, M., Wang, Y., Dasi, L. P., Armstrong, A. K., & Breuer, C. “Development of Tissue Engineered Heart Valves for Percutaneous Transcatheter Delivery in a Fetal Ovine Model”. JACC. Basic to translational science, 5(8), 815–828