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Tissue-Engineered Vascular Grafts Resist Calcification

Tissue-Engineered Vascular Grafts Resist Calcification 968 1024 Abbie Miller

Dystrophic calcification is the biggest reason for prosthetic biomaterial failure.

Compared to expanded poly(tetrafluoroethylene) (PTFE) grafts, tissue-engineered vascular grafts (TEVGs) exhibited superior durability, including reduced late-term calcification, according to a study published in Nature Communications.

“All of the biomaterials we routinely use for cardiovascular surgery are susceptible to dystrophic calcification,” says Christopher Breuer, MD, pediatric surgeon and director of the Center for Regenerative Medicine at Nationwide Children’s Hospital. “This biomineralization reduces the function of the material, whether it is functioning as a vessel or valve, and can ultimately lead to the need for replacement of the prosthetic.”

Dr. Breuer and his team have spent nearly three decades developing TEVGs that use a biodegradable scaffold seeded with the patient’s own cells. As the scaffold degrades, it is replaced with native tissue, resulting in a vessel that functions and grows with the patient — an important aspect for young patients who undergo surgery for congenital heart disease.
Their TEVG is currently the only one in clinical trials in the United States evaluating their technology in children and has recently been granted Breakthrough designation by the U.S. Food and Drug Administration (FDA). The latest study evaluates the long-term performance of the grafts compared to graft options currently in the marketplace.

Utilizing natural history data from expanded PTFE grafts, which are the most frequently used vascular conduits, and retrospective data from clinical trials and ovine model studies of TEVGs, the researchers evaluated the formation of dystrophic calcification and other biomechanical properties, including compliance mismatch. Compliance describes the change in vessel diameter over a change in pressure. Compliance mismatch refers to the difference between the compliance of the native vessel and the graft. The team then validated the findings through computational modeling.

TEVGs resisted dystrophic calcification when used as extra-cardiac conduits in the Fontan procedure (a common surgery used to treat single-ventricle disease in children). Additionally, TEVGs had better compliance matching, which allowed the graft to act more like the native vessel.

Stenosis, or narrowing of the vessel, is another risk associated with vascular grafts. The researchers used computational modeling to show that better compliance matching also prevented the formation of stenosis.

“This study further demonstrates the promise of tissue- engineered vascular grafts as long-term solutions in congenital heart surgeries,” says Dr. Breuer. “We continue to work to try to bring tissue engineering technology to the clinic in an attempt to improve outcomes for children born with congenital heart disease.”

This article also appears in the Fall/Winter 2024 print issue. Download the full issue.

 

Reference:

Turner, ME, Blum KM, Watanabe T, Schwarz EL, Nabavinia M, Leland JT, Villarreal DJ, Schwartzman WE, Chou T-H, Baker PB, Matsumura G, Krishnamurthy R, Yates AR, Hor KN, Humphrey JD, Marsden AL, Stacy MR, Shinoka T, Breuer CK. Tissue engineered vascular grafts are resistant to the formation for dystrophic calcification. Nature Communications. 2024;14:2187.

Image credit: Nationwide Children’s

About the author

Abbie (Roth) Miller, MWC, is a passionate communicator of science. As the manager, medical and science content, at Nationwide Children’s Hospital, she shares stories about innovative research and discovery with audiences ranging from parents to preeminent researchers and leaders. Before coming to Nationwide Children’s, Abbie used her communication skills to engage audiences with a wide variety of science topics. She is a Medical Writer Certified®, credentialed by the American Medical Writers Association.

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