A viable tissue engineered heart valve (TEHV) replacement would eliminate disadvantages associated with currently available prosthetics, such as thrombosis and increased risk of valve calcification. Viable TEHVs also are promising in that they can actively remodel and grow, as they would be populated with cells similar to native valves. Valvular interstitial cells (VICs) organize and maintain the complex structure of valves throughout the life of an organism. Considerable effort has been made towards identifying a source of VICs for next generation prosthetic heart valves. Despite this effort, the mechanisms by which VICs are produced in development, via endocardial epithethelial-to-mesenchymal transformation (EMT), are not fully understood. EMT is the critical first step in the formation of heart valve leaflets in utero, and thus a thorough understanding of the biomechanical and signaling environments that regulate EMT could lead to advancements in viable TEHVs.

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