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Journal of Healthcare Engineering
Volume 3, Issue 2, Pages 179-202
Research Article

Form Follows Function: Advances in Trilayered Structure Replication for Aortic Heart Valve Tissue Engineering

Dan T. Simionescu,2 Joseph Chen,3 Michael Jaeggli,2 Bo Wang,1 and Jun Liao1

1Tissue Bioengineering Laboratory, Department of Agricultural and Biological Engineering, Mississippi State University, Mississippi State, MS 39762, USA
2Biocompatibility and Tissue Regeneration Laboratory, Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
3Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA

Received 1 April 2011; Accepted 1 December 2011

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Tissue engineering the aortic heart valve is a challenging endeavor because of the particular hemodynamic and biologic conditions present in the native aortic heart valve. The backbone of an ideal valve substitute should be a scaffold that is strong enough to withstand billions of repetitive bending, flexing and stretching cycles, while also being slowly degradable to allow for remodeling. In this review, we highlight three overlooked aspects that might influence the long term durability of tissue engineered valves: (i) replication of the native valve trilayered histoarchitecture, (ii) duplication of the three-dimensional shape of the valve, (iii) and cell integration efforts focused on getting the right number and type of cells to the right place within the valve structure and driving them towards homeostatic maintenance of the valve matrix. We propose that the trilayered structure in the native aortic valve that includes a middle spongiosa layer cushioning the motions of the two external fibrous layers should be our template for creation of novel scaffolds with improved mechanical durability. Furthermore, since cells adapt to micro-loads within the valve structure, we believe that interstitial cell remodeling of the valvular matrix will depend on the accurate replication of the structures and loads, resulting in successful regeneration of the valve tissue and extended durability.