Development And Biomechanical Assessment Of Heart Valve Replacements Designed For In Utero Deployment

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BHAT-DISSERTATION-2023.pdf (14.47 MB)
Author(s)
Bhat, Sanchita S.
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Dasi, Lakshmi Prasad
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Wallace H. Coulter Department of Biomedical Engineering
The joint Georgia Tech and Emory department was established in 1997
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https://hdl.handle.net/1853/76807
Abstract
Congenital heart diseases (CHDs) account for nearly one third of all congenital defects. Patients born with complex congenital cardiac anomalies often require heart valve replacements in their lifetimes. These replacements are usually limited by issues related to durability, patient-prosthesis mismatch and lack of surgical options. Other ways to correct congenital cardiac defects are surgical palliation usually carried out in stages. These surgeries are extremely invasive and carry high risk to the patient. Over time, there has been investigation into providing a permanent solution to heart valve replacements in children. Hence, the use of tissue engineering in this application is critical. Bioabsorbable materials serve as scaffold like structures to allow for cell penetration, leading to neo-tissue growth. Neo-tissue is developed using the patient’s own cells, and therefore eradicates the susceptibility of severe rejection possessing the ability to grow, repair and remodel. Fetal tissue is extremely regenerative and is known for its plasticity, therefore attempts have been made to restore biventricular healthy anatomy in utero by balloon valvuloplasty. A lot of patients that undergo this procedure develop re-atresia or re-stenosis, bringing them back to the diseased population. Therefore, this study aims to combine the knowledge on heart valve engineering and apply that toward fetal population. The development of such a tissue engineered heart valve replacement will eliminate the need for repeat interventions and serve as a permanent solution. Given the few durable options for pediatric patients, this study will improve the feasibility of developing such a device right from the manufacturing to the testing stage. This critical integration of heart valve and tissue engineering may be the first step to the solution that is needed to reverse ventricular hypoplasia and eliminate single ventricle anomalies.
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2023-12-06
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