Regenerating the heart - Stem cells and the cardiovascular system

Abstract

Valvular heart disease is a significant cause of morbidity and mortality worldwide. Current options for surgical heart valve replacement are associated with several major disadvantages as clinically available valve prostheses represent nonviable structures and lack the potential to grow, repair, and remodel. Heart valve tissue engineering represents a promising scientific concept to overcome these limitations, aiming at the fabrication of living autologous heart valves with a thrombo-resistant surface and a viable interstitium with repair and remodeling capabilities. Following the in vitro tissue engineering concept, autologous cells are harvested and seeded onto three-dimensional matrices followed by biomimetic conditioning enabling the development of neo-heart valve tissue. Here, we review the concept of both in vitro and in vivo heart valve tissue engineering, focusing in particular on different synthetic scaffold materials and available cell sources for the fabrication of living autologous heart valve substitutes.