Objective: To describe a particular harvesting procedure for isolating intact porcine aortic heart valve roots as potential sources for biologic scaffolds.
Methods: Fresh porcine hearts were brought to the Tissue Engineering and Regenerative Medicine Laboratory at the University of Medicine and Pharmacy in Targu Mures. The aortic roots were extracted from the porcine hearts by anatomical dissection. For this purpose, we used a basic surgical instrument kit. This initial phase was the first step in obtaining acellular extracellular matrix as a biologic scaffold material.
Results: Aortic roots were isolated with preservation of the ascending aorta as well as the intact aortic sinus and coronaries together with the adjacent myocardial tissue and anterior leaflet of the mitral valve. This approach allowed for safe mounting of roots into mounting rings for perfusion decellularization.
Conclusions: The described procedure is a feasible protocol for obtaining intact biological valvular scaffolds from porcine hearts. Reduced requirements regarding tools and personnel underline the easiness of aortic root harvesting using this particular procedure.
2. Butcher JT, Nerem RM - Porcine aortic valve interstitial cells in three-dimensional culture: comparison of phenotype with aortic smooth muscle cells. J Heart Valve Dis. 2004 May;13:478–85.
3. van Geldorp MW, Jamieson E, Kappetein WR, et al - Patient outcome after aortic valve replacement with a mechanical or biological prosthesis: weighing lifetime anticoagulant related event risk against reoperation risk. J Thorac Cardiovasc. 2009 Apr;137(4):881–6.
4. Schoen FJ, Levy RJ - Pathology of Substitute Heart Valves: New Concepts and Developments. J Card Surg. 1994 Mar;9:222–7.
5. Butler DL, Goldstein SA, Guilak F - Functional tissue engineering: the role of biomechanics. J Biomech Eng. 2000 Dec;122:570 – 5.
6. Guo B, Lei B, Li P, et al. - Functionalized Scaffolds to Enhance Tissue Regeneration. Regener Biomater. 2015 Jan;2(1):47–57.
7. Do A-V, Khorsand B, Geary SM, et al - 3D printing of scaffolds for tissue regeneration applications. Adv Healthcare Mater. 2015 Aug;4:1742–62.
9. Rieder E, Kasimir M-T, Silberhumer G, et al - Decellularization protocols of porcine heart valves differ importantly in efficiency of cell removal and susceptibility of the matrix to recellularization with human vascular cells. J Thorac Cardiovasc Surg. 2004 Feb;127(2):399–05.
10. Booth C, Korossis S, Wilcox HE, et al - Tissue engineering of cardiac valve prostheses I: development and histological characterization of an acellular porcine scaffold. J Heart Valve Dis. 2002 Jul;11(4):457-62.
11. Yang M, Lin YH, Shi W, et al - Surface heparin treatment of the decellularized porcine heart valve: Effect on tissue calcification. J Biomed Mater Res B Appl Biomater. 2017 Feb;105(2):231–466.
12. Korossis SA, Wilcox HE, Watterson KG, et al - In-vitro assessment of the functional performance of the decellularized intact porcine aortic root. J Heart Valve Dis. 2005 May;14(3):408-21.
13. de Kerchove L, Jashari R., Boodhwani M, et al - Surgical anatomy of the aortic root: implication for valve sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surg. 2015 Feb;149(2):425-33.
14. Simon P, Kasimir MT, Seebacher G, Weigel G, et al - Early failure of the tissue engineered porcine heart valve synergraft in pediatric patients. Eur J Cardiothorac Surg. 2003 Jun;23(6):1002-6;discussion 1006.
15. Bentall HH, De Bono A - A technique for complete replacement of the ascending aorta. Thorax. 1968 Jul;23:338–39.
16. Stewart AS, Takayama H, Smith CR - Modified Bentall operation with a novel biologic valved conduit. Ann Thorac Surg. 2010 Mar;89(3):938-41.
17. Hussain G, Ahmad N, Ahmad S, et al - New modification of modified bentall procedure (A single centre experience). Pak J Med Sci. 2015 Nov-Dec;31(6):1318–1321.
18. Hashimoto W, Hashizume K, Ariyoshi T, et al - Ten Years Experience of Aortic Root Replacement Using a Modified Bentall Procedure with a Carrel Patch and Inclusion Technique. Ann Vasc Dis. 2011 Feb;4(1):32–36.