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• W3144947025 abstract "Cardiovascular disease is one of the main causes of death in the industrialized society. In 2009, 87.534 and 17.583 patients were hospitalized in the Netherlands for treatment of ischemic heart disease and peripheral arterial disease, respectively. In both patient populations, the mortality rates are approximately 12 % (1). For the treatment of cardiovascular disease, functional vascular grafts with an inner diameter less than 6 mm are needed. The availability and quality of autologous bypass grafts (e.g. mammary artery, saphenous vein) is frequently limited, especially in elderly patients. Although synthetic vascular grafts made from the polymers Dacron or Teflon perform reasonably well in large-diameter applications, these prostheses fail in small-diameter reconstructions due to thrombus formation and intima hyperplasia, hampering successful treatment of these patients. Vascular tissue engineering As shown during the last 10-15 years, tissue engineering is a promising technique to prepare functional small-diameter arterial grafts. Vascular smooth muscle cells (SMCs) of the patient are cultured and subsequently seeded in biodegradable porous tubular scaffolds. The resulting constructs are mounted in a pulsatile flow bioreactor and perfused for a period up to several weeks, during which the medial layer of the graft develops. Subsequently, autologous endothelial cells (ECs) are seeded on the luminal surface, after which the grafts are perfused for an additional period of several days (2). In alternative procedures, autologous stem cells have been used (e.g. mesenchymal stem cells from bone marrow). Moreover, for low pressure reconstructions such as the pulmonary artery, constructs have been implanted immediately after mesenchymal stem cell seeding (3). The ideal scaffold for vascular tissue engineering is biocompatible, flexible, elastic and biodegradable. To facilitate formation of the medial layer of the graft, the pore structure should be interconnected to provide a three-dimensional space for adhesion, proliferation and differentiation of the cells, and to allow diffusion of nutrients and metabolic waste products. Moreover, the scaffold should maintain suitable mechanical properties until maturation of the newly formed vascular tissue (4, 5). The pulsatile flow bioreactor has to mimic the blood circulation in terms of flow rate, pressure and pulse frequency. The constructs are perfused with culture media optimized for the culturing of SMCs and ECs, respectively. In the case of stem cell seeding, the culture media can be supplemented with appropriate differentiation factors." @default.
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• W3144947025 date "2012-01-01" @default.
• W3144947025 modified "2023-09-24" @default.
• W3144947025 title "Vascular tissue engineering" @default.
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