Abstract
Congenital heart disease (CHD) is the most predominant birth defect and can require several
invasive surgeries throughout childhood. The absence of materials with growth and remodelling
potential is a limitation of currently used prosthetics in cardiovascular surgery, as well as their
susceptibility to calcification. The field of tissue engineering has emerged as a regenerative medicine
approach aiming to develop durable scaffolds possessing the ability to grow and remodel upon
implantation into the defective hearts of babies and children with CHD. Though tissue engineering
has produced several synthetic scaffolds, most of them failed to be successfully translated in this lifeendangering
clinical scenario, and currently, biological scaffolds are the most extensively used. This
review aims to thoroughly summarise the existing biological scaffolds for the treatment of paediatric
CHD, categorised as homografts and xenografts, and present the preclinical and clinical studies.
Fixation as well as techniques of decellularisation will be reported, highlighting the importance
of these approaches for the successful implantation of biological scaffolds that avoid prosthetic
rejection. Additionally, cardiac scaffolds for paediatric CHD can be implanted as acellular prostheses,
or recellularised before implantation, and cellularisation techniques will be extensively discussed.
invasive surgeries throughout childhood. The absence of materials with growth and remodelling
potential is a limitation of currently used prosthetics in cardiovascular surgery, as well as their
susceptibility to calcification. The field of tissue engineering has emerged as a regenerative medicine
approach aiming to develop durable scaffolds possessing the ability to grow and remodel upon
implantation into the defective hearts of babies and children with CHD. Though tissue engineering
has produced several synthetic scaffolds, most of them failed to be successfully translated in this lifeendangering
clinical scenario, and currently, biological scaffolds are the most extensively used. This
review aims to thoroughly summarise the existing biological scaffolds for the treatment of paediatric
CHD, categorised as homografts and xenografts, and present the preclinical and clinical studies.
Fixation as well as techniques of decellularisation will be reported, highlighting the importance
of these approaches for the successful implantation of biological scaffolds that avoid prosthetic
rejection. Additionally, cardiac scaffolds for paediatric CHD can be implanted as acellular prostheses,
or recellularised before implantation, and cellularisation techniques will be extensively discussed.
| Original language | English |
|---|---|
| Article number | 57 |
| Pages (from-to) | 1-27 |
| Journal | Bioengineering |
| Volume | 10 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2 Jan 2023 |
Bibliographical note
Funding Information:The authors want to acknowledge the generous support of the British Heart Foundation (AA/18/1/34219, CH/17/1/32804), the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre (BRC), and the Grand Appeal (Bristol Children’s Hospital Charity).
Publisher Copyright:
© 2023 by the authors.