Pericardial heart valve replacement and methods of constructing the same
First Claim
1. A method of constructing a pericardial heart valve replacement made from tissue of living autologous pericardium comprising:
- determining the size and shape of the patient'"'"'s native pathological heart valve by real-time three-dimensional transesophageal echocardiography (TEE) or computer tomography (CT angiography) or by magnetic resonance imaging (MRI);
constructing a living pericardial heart valve replacement for stented or stentless implantation from a single sheet of dynamically conditioned living autologous pericardium containing living pericardial interstitial cells (PICs) and a living extracellular matrix (ECM);
tailoring the size and shape of the heart valve replacement so as to match the size and shape of the patient'"'"'s native heart valve and aortic root; and
dynamic conditioning and hemodynamic testing for conditioning and modification of the living autologous pericardium a device for a period of approximately 7 to 21 days in a device, the device comprising a hydrodynamic circuit of an artificial heart whereby hemodynamic loading of the living pericardial heart valve replacement induces pericardial interstitial cell (PIC) activation and phenotypic differentiation resulting in the production and remodeling of pericardial extracellular matrix (ECM) with an increase in the content of collagen and elastic fibers and glycosaminoglycans, thereby improving the mechanobiological and hemodynamic properties of the living pericardial heart valve replacement.
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Accused Products
Abstract
The pericardial heart valve replacement (1) is constructed from living tissue of autologous pericardium containing living pericardial interstitial cells (PICs) and a living extracellular matrix (ECM) in the following way: in the first step the size and shape of the patient'"'"'s native pathological heart valve is determined using real-time three-dimensional transesophageal echocardiography (TEE) or computer tomography (CT angiography) or magnetic resonance imaging (MRI); in the next step a stented (2) or a stentless pericardial heart valve replacement (1) is constructed from a single sheet of living autologous pericardium obtained from the patient; the size and shape of the pericardial heart valve replacement (1) corresponds to the size and shape of the patient'"'"'s native heart valve and aortic or pulmonary root. The subject matter of the invention also includes the development of a device (5) for the conditioning and modification of the living autologous pericardial heart valve replacement (1) consisting of a ipulsatile pump (6) driving the flow of culture medium in the device (5) to perfuse the cells in the pericardium, a reservoir (7) regulating the fluid capacitance and function of the pericardial heart valve replacement (1), a chamber (8) containing a holder (9) for the placement of the pericardial heart valve replacement (1) during dynamic conditioning, and a gas exchanger (10a, b) for perfusing CO2 into the culture medium. The reservoir (7), the chamber (8) and the gas exchanger (10a, b) are placed in an incubator (11) with an inner atmosphere of air mixed with 5% CO2 and a temperature of 36 to 37° C., the individual components of the device (5) being connected by tubing (12).
10 Citations
7 Claims
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1. A method of constructing a pericardial heart valve replacement made from tissue of living autologous pericardium comprising:
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determining the size and shape of the patient'"'"'s native pathological heart valve by real-time three-dimensional transesophageal echocardiography (TEE) or computer tomography (CT angiography) or by magnetic resonance imaging (MRI); constructing a living pericardial heart valve replacement for stented or stentless implantation from a single sheet of dynamically conditioned living autologous pericardium containing living pericardial interstitial cells (PICs) and a living extracellular matrix (ECM); tailoring the size and shape of the heart valve replacement so as to match the size and shape of the patient'"'"'s native heart valve and aortic root; and dynamic conditioning and hemodynamic testing for conditioning and modification of the living autologous pericardium a device for a period of approximately 7 to 21 days in a device, the device comprising a hydrodynamic circuit of an artificial heart whereby hemodynamic loading of the living pericardial heart valve replacement induces pericardial interstitial cell (PIC) activation and phenotypic differentiation resulting in the production and remodeling of pericardial extracellular matrix (ECM) with an increase in the content of collagen and elastic fibers and glycosaminoglycans, thereby improving the mechanobiological and hemodynamic properties of the living pericardial heart valve replacement. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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Specification