Pulmonary valve tissue engineering strategies in large animal models

In the last 25 years, numerous tissue engineered heart valve (TEHV) strategies have been studied in large animal models. To evaluate, qualify and summarize all available publications, we conducted a systematic review and meta-analysis. We identified 80 reports that studied TEHVs of synthetic or natu...

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Bibliographic Details
Published in:PloS one 2021-10, Vol.16 (10), p.e0258046-e0258046
Main Authors: Uiterwijk, M, van der Valk, D. C, van Vliet, R, de Brouwer, I. J, Hooijmans, C. R, Kluin, J
Format: Article
Language:English
Subjects:
Animal models
Animal models in research
Animal tissues
Animals
Biology and Life Sciences
Engineering and Technology
Heart
Heart valves
Heterogeneity
Medicine and Health Sciences
Meta-analysis
Methods
Mortality
Physical Sciences
Prostheses
Pulmonary valve
Quality assessment
Quality control
Questionnaires
Regurgitation
Research and Analysis Methods
Reviews
Scaffolds
Subgroups
Systematic review
Tissue engineering
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Summary:In the last 25 years, numerous tissue engineered heart valve (TEHV) strategies have been studied in large animal models. To evaluate, qualify and summarize all available publications, we conducted a systematic review and meta-analysis. We identified 80 reports that studied TEHVs of synthetic or natural scaffolds in pulmonary position (n = 693 animals). We identified substantial heterogeneity in study designs, methods and outcomes. Most importantly, the quality assessment showed poor reporting in randomization and blinding strategies. Meta-analysis showed no differences in mortality and rate of valve regurgitation between different scaffolds or strategies. However, it revealed a higher transvalvular pressure gradient in synthetic scaffolds (11.6 mmHg; 95% CI, [7.31-15.89]) compared to natural scaffolds (4,67 mmHg; 95% CI, [3,94-5.39]; p = 0.003). These results should be interpreted with caution due to lack of a standardized control group, substantial study heterogeneity, and relatively low number of comparable studies in subgroup analyses. Based on this review, the most adequate scaffold model is still undefined. This review endorses that, to move the TEHV field forward and enable reliable comparisons, it is essential to define standardized methods and ways of reporting. This would greatly enhance the value of individual large animal studies.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0258046