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Brimmer S, Ji P, Birla AK, Keswani SG, Caldarone CA, Birla RK. Recent advances in biological pumps as a building block for bioartificial hearts. Front Bioeng Biotechnol 2023; 11:1061622. [PMID: 36741765 PMCID: PMC9895798 DOI: 10.3389/fbioe.2023.1061622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
The field of biological pumps is a subset of cardiac tissue engineering and focused on the development of tubular grafts that are designed generate intraluminal pressure. In the simplest embodiment, biological pumps are tubular grafts with contractile cardiomyocytes on the external surface. The rationale for biological pumps is a transition from planar 3D cardiac patches to functional biological pumps, on the way to complete bioartificial hearts. Biological pumps also have applications as a standalone device, for example, to support the Fontan circulation in pediatric patients. In recent years, there has been a lot of progress in the field of biological pumps, with innovative fabrication technologies. Examples include the use of cell sheet engineering, self-organized heart muscle, bioprinting and in vivo bio chambers for vascularization. Several materials have been tested for biological pumps and included resected aortic segments from rodents, type I collagen, and fibrin hydrogel, to name a few. Multiple bioreactors have been tested to condition biological pumps and replicate the complex in vivo environment during controlled in vitro culture. The purpose of this article is to provide an overview of the field of the biological pumps, outlining progress in the field over the past several years. In particular, different fabrication methods, biomaterial platforms for tubular grafts and examples of bioreactors will be presented. In addition, we present an overview of some of the challenges that need to be overcome for the field of biological pumps to move forward.
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Affiliation(s)
- Sunita Brimmer
- Laboratory for Regenerative Tissue Repair, Texas Children’s Hospital, Houston, TX, United States,Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States,Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, TX, United States
| | - Pengfei Ji
- Laboratory for Regenerative Tissue Repair, Texas Children’s Hospital, Houston, TX, United States,Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States,Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, TX, United States
| | - Aditya K. Birla
- Laboratory for Regenerative Tissue Repair, Texas Children’s Hospital, Houston, TX, United States,Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States
| | - Sundeep G. Keswani
- Laboratory for Regenerative Tissue Repair, Texas Children’s Hospital, Houston, TX, United States,Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States,Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Houston, TX, United States
| | - Christopher A. Caldarone
- Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States,Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, TX, United States,Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Houston, TX, United States
| | - Ravi K. Birla
- Laboratory for Regenerative Tissue Repair, Texas Children’s Hospital, Houston, TX, United States,Center for Congenital Cardiac Research, Texas Children’s Hospital, Houston, TX, United States,Division of Congenital Heart Surgery, Texas Children’s Hospital, Houston, TX, United States,Department of Surgery, Baylor College of Medicine, Houston, TX, United States,Division of Pediatric Surgery, Department of Surgery, Texas Children’s Hospital, Houston, TX, United States,*Correspondence: Ravi K. Birla,
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Birla AK, Brimmer S, Short WD, Olutoye OO, Shar JA, Lalwani S, Sucosky P, Parthiban A, Keswani SG, Caldarone CA, Birla RK. Current state of the art in hypoplastic left heart syndrome. Front Cardiovasc Med 2022; 9:878266. [PMID: 36386362 PMCID: PMC9651920 DOI: 10.3389/fcvm.2022.878266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022] Open
Abstract
Hypoplastic left heart syndrome (HLHS) is a complex congenital heart condition in which a neonate is born with an underdeveloped left ventricle and associated structures. Without palliative interventions, HLHS is fatal. Treatment typically includes medical management at the time of birth to maintain patency of the ductus arteriosus, followed by three palliative procedures: most commonly the Norwood procedure, bidirectional cavopulmonary shunt, and Fontan procedures. With recent advances in surgical management of HLHS patients, high survival rates are now obtained at tertiary treatment centers, though adverse neurodevelopmental outcomes remain a clinical challenge. While surgical management remains the standard of care for HLHS patients, innovative treatment strategies continue to be developing. Important for the development of new strategies for HLHS patients is an understanding of the genetic basis of this condition. Another investigational strategy being developed for HLHS patients is the injection of stem cells within the myocardium of the right ventricle. Recent innovations in tissue engineering and regenerative medicine promise to provide important tools to both understand the underlying basis of HLHS as well as provide new therapeutic strategies. In this review article, we provide an overview of HLHS, starting with a historical description and progressing through a discussion of the genetics, surgical management, post-surgical outcomes, stem cell therapy, hemodynamics and tissue engineering approaches.
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Affiliation(s)
- Aditya K. Birla
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
| | - Sunita Brimmer
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Walker D. Short
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Oluyinka O. Olutoye
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Jason A. Shar
- Department of Mechanical Engineering, Kennesaw State University, Marietta, GA, United States
| | - Suriya Lalwani
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
| | - Philippe Sucosky
- Department of Mechanical Engineering, Kennesaw State University, Marietta, GA, United States
| | - Anitha Parthiban
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
- Division of Pediatric Cardiology, Texas Children's Hospital, Houston, TX, United States
| | - Sundeep G. Keswani
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Christopher A. Caldarone
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX, United States
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
| | - Ravi K. Birla
- Laboratory for Regenerative Tissue Repair, Texas Children's Hospital, Houston, TX, United States
- Center for Congenital Cardiac Research, Texas Children's Hospital, Houston, TX, United States
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX, United States
- Department of Surgery, Baylor College of Medicine, Houston, TX, United States
- Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, United States
- *Correspondence: Ravi K. Birla
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Blum KM, Mirhaidari G, Breuer CK. Tissue engineering: Relevance to neonatal congenital heart disease. Semin Fetal Neonatal Med 2022; 27:101225. [PMID: 33674254 PMCID: PMC8390581 DOI: 10.1016/j.siny.2021.101225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Congenital heart disease (CHD) represents a large clinical burden, representing the most common cause of birth defect-related death in the newborn. The mainstay of treatment for CHD remains palliative surgery using prosthetic vascular grafts and valves. These devices have limited effectiveness in pediatric patients due to thrombosis, infection, limited endothelialization, and a lack of growth potential. Tissue engineering has shown promise in providing new solutions for pediatric CHD patients through the development of tissue engineered vascular grafts, heart patches, and heart valves. In this review, we examine the current surgical treatments for congenital heart disease and the research being conducted to create tissue engineered products for these patients. While much research remains to be done before tissue engineering becomes a mainstay of clinical treatment for CHD patients, developments have been progressing rapidly towards translation of tissue engineering devices to the clinic.
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Affiliation(s)
- Kevin M Blum
- Center for Regenerative Medicine, The Abigail Wexner Research Institute, Nationwide Childrens Hospital, Columbus, OH, USA; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.
| | - Gabriel Mirhaidari
- Center for Regenerative Medicine, The Abigail Wexner Research Institute, Nationwide Childrens Hospital, Columbus OH, USA,Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus OH, USA
| | - Christopher K Breuer
- Center for Regenerative Medicine, The Abigail Wexner Research Institute, Nationwide Childrens Hospital, Columbus, OH, USA.
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