Využití mechanismů tkáňové modifikace k přípravě autologní perikardiální chlopenní náhrady

Currently used xenogeneic biological heart valves have several limitations in clinical practice. The main problem is the development of degenerative changes leading to valve failure. Re-surgery is required in approximately 65% of patients at 15 years after implantation. The challenge of heart valve...

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Bibliographic Details
Main Author: Straka, František
Other Authors: Pirk, Jan
Format: Doctoral Thesis
Language:English
Published: 2016
Online Access:http://www.nusl.cz/ntk/nusl-351313
Description
Summary:Currently used xenogeneic biological heart valves have several limitations in clinical practice. The main problem is the development of degenerative changes leading to valve failure. Re-surgery is required in approximately 65% of patients at 15 years after implantation. The challenge of heart valve tissue engineering is to create a new type of autologous biological heart valve prosthesis for clinical use with living cells capable of valve tissue remodeling. Several approaches are used with different types of scaffolds, and with a variety of cells and laboratory protocols. Most of them have not proven themselves, due to limitations such as scaffold immune system incompatibility, non-optimal mechanical properties, scaffold shrinkage, poor cell penetration, low extracellular matrix production and poor biomechanical properties and no remodeling potential after implantation in vivo. In the first part of the research, the objective is to compare the cellular matrix, the extracellular matrix structure and the mechanical properties of human pericardium as a potential scaffold for autologous heart valve tissue engineering with the structure of the normal human aortic heart valve. The second part of the research deals with the preparation of a dynamic culture system (a bioreactor) for in vivo human...