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Review
. 2022 Jan 10;23(2):723.
doi: 10.3390/ijms23020723.

Tissue Engineered Transcatheter Pulmonary Valved Stent Implantation: Current State and Future Prospect

Affiliations
Review

Tissue Engineered Transcatheter Pulmonary Valved Stent Implantation: Current State and Future Prospect

Xiling Zhang et al. Int J Mol Sci. .

Abstract

Patients with the complex congenital heart disease (CHD) are usually associated with right ventricular outflow tract dysfunction and typically require multiple surgical interventions during their lives to relieve the right ventricular outflow tract abnormality. Transcatheter pulmonary valve replacement was used as a non-surgical, less invasive alternative treatment for right ventricular outflow tract dysfunction and has been rapidly developing over the past years. Despite the current favorable results of transcatheter pulmonary valve replacement, many patients eligible for pulmonary valve replacement are still not candidates for transcatheter pulmonary valve replacement. Therefore, one of the significant future challenges is to expand transcatheter pulmonary valve replacement to a broader patient population. This review describes the limitations and problems of existing techniques and focuses on decellularized tissue engineering for pulmonary valve stenting.

Keywords: biodegradable; congenital heart disease; decellularization; heart valve replacement; nitinol; percutaneous; pulmonary; recellularization; stents; tissue engineering; transcatheter.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Medtronic Melody Pulmonary valve, comprised of a bovine jugular vein valve sutured within a platinum iridium frame; with the permission of reproduction by Medtronic Inc. (B) Edwards SAPIEN 3 valve, made of bovine pericardial tissue attached to a balloon-expandable, cobalt-chromium frame for support; with the permission of reproduction by Edwards Lifesciences Inc. (C) Medtronic HARMONY Transcatheter Pulmonary Valve, comprised of porcine pericardial tissue valve and self-expanding nitinol frame with polyester cloth covering; with the permission of reproduction by Medtronic Inc. (D) VenusP-Valve, consisting of a self-expanding stent made of nitinol with a tri-leaflet porcine pericardial tissue; with the permission of reproduction by Venus Medtech Inc. (E) Edwards SAPIEN XT valve, made of bovine pericardial tissue with high radial strength cobalt-chromium frame with low frame height design; with the permission of reproduction by Edwards Lifesciences Inc.
Figure 2
Figure 2
New device: (A) An end-on-view of the new device showing the Nitinol stent with graft covering and the open pericardial valve leaflets. (B) The delivery system with the device crimped and loaded onto the distal end (right side of picture) [30].
Figure 3
Figure 3
(A) Self-expanding nitinol stent, sizes 24 mm (ventricular)/22 mm (middle)/20 mm (pulmonary) with an overall length of 35 mm. (B) Top view of tricuspid polycarbonate urethane valved stent. (C) The valved stent is crimped in a 14-Fr delivery catheter with a smooth silicone structure at the proximal tip [97].
Figure 4
Figure 4
(A,B) Gross morphology of tissue-engineered pulmonary valved stent [100,101].

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