Towards a Tissue Engineered Heart Valve Bioreactor and a Coptic Ethic for Tissue Engineering

Abstract

Valvular disease is among the leading causes of death worldwide. Tissue-engineered heart valves (TEHV) represent a promising treatment for valvular disease that address the limitations of current valve prostheses. Valve scaffolds that can regenerate native tissue architecture are of particular interest because of their ability to potentiate cell alignment and mediate the forces which valvular tissue experiences. To advance this tissue-engineering approach, however, there is a need for an in vitro, reproducible system capable of testing TEHVs and exposing them to physiologically relevant hydrodynamic conditions. The goal of this project was to develop a cardiac valve bioreactor system capable of conditioning living valves with a range of fluid dynamics according to ISO 5840 standards. A bioreactor system was designed based on the Windkessel model of the cardiac cycle and included novel features such as a custom valve chamber with multiple angles of optically clear visibility of the valve conducive to live imaging. Computational Fluid Dynamics revealed that the design is capable of achieving close to physiological fluid dynamics. The bioreactor system is able to produce physiological ventricular pressure and flow through the valve. However, there remains opportunity for improvement on the aortic side with clear directions for achieving sustained aortic pressure. Flow conditions allowing for adequate opening and closure of TEHVs and stepwise conditioning protocols for each unique TEHV design. This project then proceeds with a theological reading of tissue engineering as a case study for developing Coptic Orthodox bioethics.