biomimetic engineered chordae tendineae for valve repair and regeneration

Descrizione del progetto

La tecnologia rigenerativa per riparare la valvola mitrale

Le malattie cardiache, in particolare quelle che colpiscono la valvola mitrale, sono una delle principali cause di decesso a livello globale, soprattutto tra le persone di età superiore ai 65 anni. Il rigurgito della valvola mitrale, causato da un danno alle corde tendinee della stessa, interessa milioni di persone e viene solitamente trattato mediante la sostituzione di tali corde con politetrafluoroetilene espanso (ePTFE); ciononostante, questo metodo può portare a complicazioni come la rottura e la calcificazione. Il progetto BioChord, finanziato dal CER, offre un’alternativa innovativa in tal senso, ovvero una corda tendinea rigenerativa polimerica bioingegnerizzata. Il progetto si propone di riparare la valvola per poi consentire un’integrazione graduale della sua soluzione con il tessuto del paziente, dando vita a una struttura funzionale che imita la corda tendinea innata e fornisce supporto meccanico a lungo termine al cuore.

Obiettivo

The human heart is among those organs suffering from a limited capacity to self-regenerate. Heart diseases continue to be a leading cause of mortality with suboptimal therapeutic options. Thus, deploying new therapeutic strategies for tissue repair is a primary objective in modern cardiac medicine. Valvular heart diseases, such as those related to the Mitral Valve (MV), are the leading causes of cardiovascular morbidity and mortality worldwide, affecting 5.1% of the 65+ years old population. In particular, MV regurgitation, one of the most common valvopathies, affects over 24 million people worldwide. Since the fundamental nature of MV regurgitation is mechanical, caused by physical, irreversible damage to the restraining force structures of the valvular apparatus, the only effective treatment is limited to the surgical approaches that include MV repair or replacement. However, when the regurgitation is due to Chordae Tendinae (CT) elongation or rupture, several studies have demonstrated the substantial advantages of MV repair, using a substitute for the damaged CT vs. MV replacement. Currently, the expanded polytetrafluoroethylene (ePTFE) has become the standard approach in CT repair/replacement1. However, several complications (rupture, calcification, detachment, fibrosis, and slippage) have been observed. Hence, there continues to be an urgent need to develop better MV repair techniques that are simple, effective, and durable. In this proposal, we intend to further advance and validate BioChord, the first ever polymeric bioengineered regenerative CT, designed to first repair the MV by replacing the diseased CT, providing mechanical support to the valvular apparatus, then to be restored by the patient tissue, progressively becoming a functional tendon-like structure that, as a native CT, while connecting the valve leaflet to the papillary muscle, will sustain the valvular apparatus with blood and nutrients.