Heart disease is the number one leading cause of death in the United States. The American Heart Association reported that heart valve surgery has been linked to 102,425 hospital discharges in 2013. Currently, several strategies are available for heart valve replacement. This includes replacement with a mechanical valve, an allograft, xenograft, or autograft (Ross procedure). However, these solutions, although proven, present challenges. For example, the shear stress exerted by mechanical valves activates platelets and the valve is a risk for thrombosis and embolism, and thus requires that the patient takes blood thinners for a lifetime. Another concern for donor grafts (human or animal) is longevity, which is limited to 10 to 15 years since tissue-based grafts have relatively poor mechanical properties.
We propose a strategy to tissue engineer the heart valve using a biodegradable scaffold matched to the patient to encourage heart valve tissue regrowth upon implantation. The heart valve scaffold will be developed by 3D printing to produce a patient-matched template onto which biodegradable polymers will be coated using electrospinning technology. The hybrid electrospinning-3D printing approach (e3DP) approach has been previously used to create vascular grafts and produced promising results upon implantation in sheep models without the addition of cells. We will adapt the e3DP approach for the heart valve, specifically to optimize the material and process parameters and assess the in vitro (fiber crystallinity and morphology, scaffold mechanical integrity and biocompatibility) and subsequently in vivo properties using an ovine model. This project aims to ultimately generate a functional patient-matched heart valve by tissue engineering using the e3DP approach.