Abstract
Vascular grafts are needed for coronary and peripheral vascular bypass surgeries as well as for access surgeries for hemodialysis and reconstruction of congenital heart defects. Despite good results in the large caliber, small caliber (<6 mm) show unsatisfactory clinical results. Tissue-engineered vascular grafts (TEVG) have been made using several approaches ranging from acellular synthetic or biologic polymer scaffolds to decellularized natural matrices, self-assembled cell-based bioreactor matured, or 3D cell-printed constructs. This chapter will focus mainly on in vivo tissue engineering which was used as first-in-man. This is based on an acellular, synthetic, degradable, polymer scaffold which is repopulated by the host cells after implantation to create a “neo-artery.” Advantages are shelf-readiness; simple, cost-effective manufacturing; and avoidance of bioreactor cell maturation. Short-, mid-, and long-term experimental and clinical results show good cellular remodeling with extracellular matrix formation and endothelialization as well as patency and function. Thus, the approach of using an acellular, synthetic, biodegradable scaffold is an optimal clinical option for TEVG.
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Acknowledgments
The authors would like to acknowledge the research groups of the Departments of Cardiovascular Surgery, Clinical Pathology, Pathology & Immunology and Pharmaceutics of the University of Geneva as well as the expert help of Mr. Jean-Pierre Giliberto from the experimental surgery laboratory.
B. H. Walpoth expresses his thanks to the Thematic Group of Vascular Tissue Engineering of TERMIS, as well as the group of the International Symposium on Vascular Tissue Engineering.
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Walpoth, B.H. et al. (2020). In Vivo Tissue-Engineered Vascular Grafts. In: Walpoth, B., Bergmeister, H., Bowlin, G., Kong, D., Rotmans, J., Zilla, P. (eds) Tissue-Engineered Vascular Grafts. Reference Series in Biomedical Engineering(). Springer, Cham. https://doi.org/10.1007/978-3-319-71530-8_7-1
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