MbShea@PWP@English@UMCP

Abstract: Cardiovascular disease is the leading cause of death and disability in the US. According to the Center of Disease Control and Prevention, cardiovascular disease is the cause of over 610, 000 deaths per year, which is about 1 in every 4 deaths. There have been decades of research focused on developing the best treatment plan for these patients. Currently, the gold standard is to use an autologous vein or artery from a different part of the body and implant it to the site of ischemia or blood clotting. However, this procedure possesses many problems. It has been reported that over 24% of bypass surgeries leads to infection at the vein harvest site. Furthermore, many autologous veins and arteries are not viable for this surgical procedure, because they don’t have the durability to withstand extraction and implantation. Many bioengineers throughout the world are trying to solve this issue with decellularized tissue engineered vascular grafts (TEVG). Usually synthesized from porcine or bovine tissue, these vascular grafts are created to resemble native vessels. To avoid immune system rejection, these tissues undergo decellularization protocol that strips away all cells and leaves the extracellular matrix untouched. Over the last decade, these methods have shown a lot of progress and promise; there have been many in-vitro and in-vivo studies that have validated the use of TEVGs in the clinic. Larger human studies are required before these bioengineered grafts revolutionize the treatment options for Cardiovascular disease.
Reader’s Profile: I imagine that a skeptical reader would be an individual ,who has or has increased risk to have cardiovascular disease, who is looking for alternative treatment plans other than saphenous vein graft bypass surgery.
Reader’s Response: Hmmm… This looks like an extremely promising novel treatment option. However, how are these tissue engineered grafts designed to make sure that it mimics the strength and morphology of each individual’s blood vessels. Blood vessels can vary in strength and morphology from individual to individual. So, I’m skeptical of how these TEVGs are specifically catered to me. I also would like to see more human studies being performed with these TEVGs before I’m comfortable with these treatment plans.

Good capture of a reluctant reader. Occurs to me, do some patients have religious objections to the use of porcine tissue? Can you look at that briefly?