A New Heart Patch for Infants That Is Made from Living Tissue

The National Institutes of Health is providing a grant to bioengineers at Rice University and Texas Children's Hospital to develop a new generation of heart patches to repair damaged hearts in infants. Rice bioengineering associate professor Jeffrey Jacot describes his team's work. 

Kristopher Sturgis

The five-year, $1.9 million grant will allow a team of bioengineers to take their new heart patch technology to the next level in an effort to improve survival rates in infants who have been diagnosed with heart defects in utero and require surgery soon after birth. Jeffrey Jacot, associate professor of bioengineering at Rice and team leader on the research, says that the goal is to create a device that can blend with the tissue to help support and promote cell behavior.

"We have concentrated on developing materials with properties similar to the native heart to make biologically inspired scaffolds to support and direct stem cell behavior," Jacot says. "In the long term, because these patches are living, we think they can be used to repair much larger sections of the heart tissue and lead to novel strategies for correction of heart defects."

Jacot says that surgeons implant over 5000 patches a year in the U.S., and most are made of plastic that cannot grow with the infant's heart, which can cause complications as the infant grows. This group will soon begin testing their new patches that encourage the child's own heart cells to invade and regenerate tissue over time to repair any birth defects.

"My colleagues and I thought that we could do better by making a living piece of tissue that can be used to repair heart defects," Jacot said. "In this project, we plan to develop a living heart patch made from cells from amniotic fluid. This living patch could be genetically matched to a newborn infant, and we hope the patch would be absorbed into the infant's heart tissue, and function and appear identical to the native heart tissue."

Jacot's initial study will be aimed at infants who suffer from Tetralogy of Fallot, a birth defect that causes blood to bypass the lungs, often resulting in blue baby syndrome. Traditionally, plastic cell-free patches are used to repair the issue, but these patches can't grow with the infant's heart, requiring replacement at several different stages. They also make it difficult for cells to survive, which is why Jacot believes that creating a patch from living tissue could be a novel solution.

"Cell survival is a major challenge," he says. "We are focusing primarily on ensuring blood supply to the patch, with the hope that this will lead to cell growth and blending with native tissue. Heart cells need a constant blood supply to survive. We have developed technology to make an immature blood supply out of stem cells from amniotic fluid that can quickly attach to native blood vessels, and will hopefully aid in survival of the patch."

The new patch also consists of a polyurethane core that's strong enough to handle sutures, as well as the stresses of a beating heart. The Texas researchers also surrounded the patch with a porous gel that will welcome cells from neighboring heart tissue.

While clinical use of the patch remains several years away, Jacot and his team continue to explore new avenues that could enhance the patch and increase its chances of success. They've even begun implementing the use of readily available amniotic stem cells from the newborn's own mother, which should cut the risk of tissue rejection even further.

For now, understanding long term success and complications remains an area of focus for the Jacot and his group.

"I think this technology will still require 10 years before it reaches [the] clinic," he says. "We need to validate and prove that these will function in the long term, and will not lead to any unforeseen complications." 

Kristopher Sturgis is a contributor to Qmed and MPMN.

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