The leading cause of death- still- is cardiovascular disease (CVD).  And, when CVD is severe, the treatment of choice is a heart transplant.  Not surprisingly, these are not always available- so the wait- assuming one gets on the list- can be 6 months, a year, or even longer.  In the US that means that 1/6 of those on the list die before ever moving up to #1 on the list.

So, we rely on LVAD (left ventricular assist devise) and other cardiac pumps.  But…

There is a push to use our 3D printing capabilities to bioprint a heart.  That means we mix cells, biomaterials, and the like to produce a device that can mimic the natural physiology and function of the heart.  Now, if we only had the perfect tissue matrix- and the ability to keep each of those cardiac cells perfectly oxygenated.

Keeping the cells oxygenated means we need  vascularization- the generation of blood vessels.  It’s been done- folks at USCD developed a 3D printed blood vessel network, implanted it into mice where they integrated with their own blood vessels and transported blood.  (Not just USCD- it’s been done at Rice University and the University of Pennsylvania.)

Then, there’s Terumo, a Japanese firm, that offers a commercially available heart sheet- and has been doing so for the past four years.  The firm harvests muscle tissue from the patient’s own leg.  This tissue is then cultured (in vitro- which means under glass, i.e., in a test tube or flask) on a tissue culture plate.  Then, once the temperature is lowered, the cells float off the surface in a sheet.  (This preserves the extracellular matrix, which is not what happens with most other cell harvesting techniques.)

This product is aimed at those with less than 35% left ventricle ejection fraction (LVEF).  But, at least according to a few researchers, this $ 125K process does not seem to improve the LVEF.  (Terumo’s device was approved by the Japanese version of the FDA using a new conditional approval system. [Think of how remdesivir was approved by the FDA for COVID-19.])

Other approaches include developing what’s called “cardiac patches”.  These are comprised of engineered cardiac tissue, which are placed directly on the scar tissue of the heart.  The goal is to boost the pumping capability of the heart and augment its structural integrity. (Last year Dr. Richard Jabbour and his colleagues of the British Heart Function Cardiovascular Regenerative Medicine Center at Imperial College, London, reported that within 3 days the patches began beating and were equivalent to mature cardiac tissue within a month. They were applied within 4 weeks of the cardiac event.  They expect to begin clinical trials soon.)

This may be one-upped by folks at the University of Tel Aviv, who plan to integrate electronic sensors (and maybe a pacemaker) within these cardiac patches.

Exciting times.

 

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