Engineering Biodegradable Vascular Scaffolds for Congenital Heart Disease

Abstract

The most common birth defects worldwide are congenital heart defects. To treat these malformations in a child’s cardiovascular system, synthetic grafts have been used as a primary intervention. However, current grafts suffer from deficiencies such as minimal biological compatibility, inability to grow and adapt, and high failure rates. Additionally, the grafts are not customized to the patient, which may lead to graft failure given that defects may vary significantly from patient to patient. The work presented here aims to adapt tissue engineering paradigms to develop customizable vascular grafts for congenital heart defects using to reduce the long-term risk and the number of surgeries experienced by patients.

The first component of this research focuses on solvent-cast vascular grafts. This system of fabrication was used to explore how various strategies and graft modifications affect the graft’s performance in vivo. Grafts were fabricated with the mechanical properties necessary to withstand the stresses of a physiological environment and support neotissue formation. To improve tissue formation, the grafts were modified with bioactive molecules to improve vascular tissue growth. In addition, the grafts were combined with a tissue perfusion bioreactor. The bioreactor applied fluid flow to support cell seeding, differentiation, and growth of endothelial progenitor cells on the grafts, demonstrating a robust strategy for tissue formation prior to implantation.

The second component of this research centers on the development of a biomaterial for 3D printing. 3D printing offers unparalleled customizability, as a graft can be designed based on medical images of a patient, tested via computer modeling, and then printed for implantation. A resin was developed consisting to produce grafts that were mechanically compatible with native blood vessels and maintained patency and tissue formation six months after implantation. The library of 3D printed vascular graft materials was also expanded by creating a novel copolymer resins, which varied in mechanical properties and degradation profiles. In addition, the concepts and strategies of biofunctionalization developed in the solvent-cast vascular grafts can be combined with the 3D printed graft strategies. Grafts designed, printed, and modified using these combinatorial approaches can greatly improve the long-term outcomes of treating congenital heart disease.