Abstract 15155: Engineered Cardiac Tissue Constructs to Aid Venous Return
INTRODUCTION: Until now, the main goal of creating engineered cardiac tissue was to restore muscle lost during myocardial infarction. Here we suggest a novel approach of using engineered cardiac tissue to treat a different set of clinical conditions such as aiding blood flow in patients suffering from chronic venous insufficiency.
Methods and Results: The strategy involves wrapping the vein of interest with layers of engineered cardiac tissue, producing an extravasal cardiomyocyte derived venous assist device (CMVAD). When grafted around a vein with functional valves the cell content of CMVAD can be a mixture of pacemaker and ventricular cells (Fig.A). As the construct matures, these cells form gap junctions with each other creating an early form of a cardiac syncytium. As a result, the CMVAD sheath contracts simultaneously while the valve within the vessel enables flow. The second type of CMVAD can be employed around vessels without functional valves or with severely damaged ones (Fig.B). They will require initial separation of pacemaker and ventricular like cells in order to create CMVAD that squeezes the vein in a peristaltic-like fashion. By using different ratios of ventricular cardiomyocytes and fibroblasts within the CMVAD scaffold one can modulate the propagation velocity and CMVAD propulsion force. Here we present proof-of-concept data for the outlined approach using excised segments of canine and porcine saphenous veins (Fig.C) and cardiac tissue constructs made from neonatal rat cardiomyocytes (Fig.D).
Conclusions: The number of people who suffer from chronic venous disease is tremendous; an estimated 25% of the adult population has varicose veins and 6% more have advanced chronic disease, leading to phlebitis, venous stasis, ulceration and limb loss. The proposed strategy would treat chronic venous disease by forming rhythmically contracting muscle layers around the veins of interest, using patient’s own induced pluripotent stem cells.
- © 2013 by American Heart Association, Inc.