Cardiovascular and pulmonary diseases are the leading causes of morbidity and mortality, being among the top 3 diseases in terms of healthcare spending worldwide. Valve replacement or repair is the 2nd most common major heart operation in the western world, whereas vascular stenting represents one of the most commonly performed procedures for treating occlusive coronary artery disease. Moreover, lung transplantation still remains the only viable option for the treatment of patients with end-stage lung diseases, such as chronic obstructive pulmonary disease (COPD), with extracorporeal membrane oxygenation (ECMO) representing the current clinical practice as a bridge to transplantation.
Currently, synthetic biomaterials chemically cross-linked animal or human donor tissues are most commonly used for cardiovascular tissue repair or replacement. However, conventional approaches only deliver inert or biocompatible material solutions that prevent cellular migration after implantation and cannot regenerate or grow with the patient. Surgeons prefer autologous tissue since it will retain viability and regenerate. However, autologous tissue is limited or not available at all. Tissue engineering offers an attractive alternative for cardiovascular tissue reconstructions, aiming to develop tailor-made, functional substitutes for implantation, with the purpose of fostering remodelling and regeneration of diseased tissue.
In the case of ECMO, the use of oxygenator devices is limited to a few weeks due to contact of the patient’s blood with the artificial components of the device, and the consequent thrombus formation and deposition of blood components within the device. The improvement of the haemocompatibility of current ECMO devices does not only have the potential to prolong ECMO usage in anticipation of a suitable lung transplant, but it can also provide a destination therapy, as an alternative to lung transplantation. To this end, surface endothelialization has been considered an effective approach to enhance long-term haemocompatibility of blood-contacting devices, such as circulatory assist devices and stents.
This seminar will present an overview of the work undertaken at Hannover Medical School in the fields of valvular tissue engineering and biohybrid devices, including artificial lung and stents.