Tissue Engineering of the Right Heart Outflow Tract by a Biofunctionalized Bioresorbable Polymeric Valved Tube

The Right Ventricular Outflow Tract (RVOT)

Numerous tubes or conduits are currently available to reconstruct the right ventricular outflow tract (RVOT) of patients with a congenital heart disease. These include cryopreserved homografts, stented heterografts (made for example of porcine aortic heart valve inserted in a textile tube), stentless heterografts (such as a part of a bovine jugular vein), but also mechanical valves, or devices for a percutaneous pulmonary valve replacement.

Unfortunately, each of these tubes has major disadvantages. Some of them present with structural degeneration with time and calcification related to an inflammatory and immune response. Other devices need an antocoagulant therapy and have a risk of cerebral stroke and bleeding. Finally, others are particularly prone to infection (endocarditis) or excessive dilation (aneurysm). None of these currently available "tools" to reconstruct this part of the heart has a potential of growth. Therefore, when implanted in a child that still needs to grow, all of these tubes need to be replaced with a new open-heart or interventional procedure.