Living tissue–engineered heart valves (TEHV) may circumvent ongoing problems in pediatric valve replacements, offering optimum hemodynamic performance and the potential for growth, remodeling, and self-repair [1]. Although a myriad of external stimuli are available in current bioreactors (e.g., oscillatory flows and mechanical conditioning), there remain significant bioengineering challenges in determining and quantifying parameters that lead to optimal extracellular matrix (ECM) development for the long-term goal of engineering TEHVs exhibiting tissue architecture and functionality equivalent to native tissue. It has become axiomatic that in vitro mechanical conditioning promotes engineered tissue formation, either in organ-level bioreactors or in tissue-level bioreactors with idealized-geometry tissue engineering (TE) constructs [2–5]. However, the underlying mechanisms remain largely unknown. Efforts to date have been largely empirical, but a two-pronged approach involving novel theoretical developments and close-looped designed experiments is necessary to reach a better mechanistic understanding of the...

References

References
1.
Stock
,
U. A.
,
Vacanti
,
J. P.
,
Mayer
, Jr.,
J. E.
, and
Wahlers
,
T.
,
2002
, “
Tissue Engineering of Heart Valves—Current Aspects
,”
Thorac. Cardiovasc. Surg.
,
50
, pp.
184
193
.10.1055/s-2002-32406
2.
Ramaswamy
,
S.
,
Gottlieb
,
D.
,
Engelmayr
, Jr.,
G. C.
,
Aikawa
,
E.
,
Schmidt
,
D. E.
,
Gaitan-Leon
,
D. M.
,
Sales
,
V. L.
,
Mayer
, Jr.,
J. E.
, and
Sacks
,
M. S.
,
2010
, “
The Role of Organ Level Conditioning on the Promotion of Engineered Heart Valve Tissue Development In Vitro Using Mesenchymal Stem Cells
,”
Biomaterials
,
31
, pp.
1114
1125
.10.1016/j.biomaterials.2009.10.019
3.
Engelmayr
, Jr.,
G. C.
,
Rabkin
,
E.
,
Sutherland
,
F. W.
,
Schoen
,
F. J.
,
Mayer
, Jr.,
J. E.
, and
Sacks
,
M. S.
,
2005
, “
The Independent Role of Cyclic Flexure in the Early In Vitro Development of an Engineered Heart Valve Tissue
,”
Biomaterials
,
26
, pp.
175
187
.10.1016/j.biomaterials.2004.02.035
4.
Engelmayr
, Jr.,
G. C.
,
Sales
,
V. L.
,
Mayer
, Jr.,
J. E.
, and
Sacks
,
M. S.
,
2006
, “
Cyclic Flexure and Laminar Flow Synergistically Accelerate Mesenchymal Stem Cell-Mediated Engineered Tissue Formation: Implications for Engineered Heart Valve Tissues
,”
Biomaterials
,
27
, pp.
6083
6095
.10.1016/j.biomaterials.2006.07.045
5.
Engelmayr
, Jr.,
G. C.
,
Soletti
,
L.
,
Vigmostad
,
S. C.
,
Budilarto
,
S. G.
,
Federspiel
,
W. J.
,
Chandran
,
K. B.
,
Vorp
,
D. A.
, and
Sacks
,
M. S.
,
2008
, “
A Novel Flex-Stretch-Flow Bioreactor for the Study of Engineered Heart Valve Tissue Mechanobiology
,”
Ann. Biomed. Eng.
,
36
, pp.
700
712
.10.1007/s10439-008-9447-6
You do not currently have access to this content.