计算机建模+组织工程=心脏病患者福音
Patients with valvular heart disease such as aortic stenosis (narrowing of the aortic valve in the heart) receive artificial or bioprosthetic valve replacements, but these have limited longevity and cannot grow with younger patients.
患有心血管疾病，比如主动脉瓣狭窄的患者可以接受人工或者人造生物瓣膜移植物，不过它们的寿命有限，不能跟那些更年轻的患者一起生长。
Emmert et al. used computational modeling to design tissue-engineered heart valves from polymer scaffolds seeded with vascular cells.
埃默特等利用计算机建模技术通过给聚合物支架种植血管细胞而设计出了组织工程的心脏瓣膜。
After 4 weeks of bioreactor culture, the grafts were decellularized before transcatheter implantation in sheep as pulmonary valve replacements.
经过四周的生物反应器培养，这些人造物脱细胞后经导管移植入羊体内作为肺动脉瓣替代物。
Nine of the 11 grafts remained functional up to 1 year later.
一年后，11个人造瓣膜中有9个还能继续维持功能。
Computational modeling predicted that valve leaflets would shorten in vivo during dynamic remodeling before reaching equilibrium, which was confirmed in the sheep.
计算机模型预测瓣膜叶会在体内动态重组期间缩短然后达到平衡，这一预测在羊的活体实验中得到了证实。
This work suggests that tissue engineering strategies should incorporate computational simulation to lead to more successful outcomes and more predictable clinical translation.
该研究表明组织工程技术应该与计算机仿真结合，才会带来更成功的结果和更多可预测的临床移植。
Valvular heart disease is a major cause of morbidity and mortality worldwide.
心血管疾病是全世界发病率和死亡率很高的一大疾病。
Current heart valve prostheses have considerable clinical limitations due to their artificial, nonliving nature without regenerative capacity.
现有的人造心脏瓣膜临床使用寿命都很有限，这是因为它们的人造的，非生物，没有再生能力的本质。
To overcome these limitations, heart valve tissue engineering (TE) aiming to develop living, native-like heart valves with self-repair, remodeling, and regeneration capacity has been suggested as next-generation technology.
为了克服这些限制，心脏瓣膜组织工程（TE）的目标就是要研发出活体的，跟自然相似的心脏瓣膜，它们有自我修复，重组和再生能力，被认为是该技术的未来。
A major roadblock to clinically relevant, safe, and robust TE solutions has been the high complexity and variability inherent to bioengineering approaches that rely on cell-driven tissue remodeling.
而研发临床相关的，安全而耐用的TE制品的一大主要障碍，就是依赖细胞生长的组织重组的生物工程方法本身高度的复杂多变性。
For heart valve TE, this has limited long-term performance in vivo because of uncontrolled tissue remodeling phenomena, such as valve leaflet shortening, which often translates into valve failure regardless of the bioengineering methodology used to develop the implant.
对于心脏瓣膜组织工程来说，移植物在体内的工作期限有限，因为会发生不可控的组织重组现象，例如瓣膜叶的缩短，而这经常会导致瓣膜失效，哪怕它们是用生物工程技术研发出来的移植物。
We tested the hypothesis that integration of a computationally inspired heart valve design into our TE methodologies could guide tissue remodeling toward long-term functionality in tissue-engineered heart valves (TEHVs).
我们对一个假设进行了测定，就是在我们的TE方法设计中整合了计算机支持的心脏瓣膜设计可以指导组织重建过程朝着TEHV的长期功能方向发展。
In a clinically and regulatory relevant sheep model, TEHVs implanted as pulmonary valve replacements using minimally invasive techniques were monitored for 1 year via multimodal in vivo imaging and comprehensive tissue remodeling assessments.
在临床和相关的羊调控模型实验中，利用微创技术将TEHV移植物作为肺动脉瓣替代物，然后通过多通道体内成像和组织重组综合评估，进行了为期一年的监测。
TEHVs exhibited good preserved long-term in vivo performance and remodeling comparable to native heart valves, as predicted by and consistent with computational modeling.
TEHV显示出了在体内良好的长期功能性，重组过程跟天然的心脏瓣膜相似，跟计算机建模预测的结果一致。
TEHV failure could be predicted for nonphysiological pressure loading.
TEHV的失效也可以在不施加生理压力的情况下被预测出来。
Beyond previous studies, this work suggests the relevance of an integrated in silico, in vitro, and in vivo bioengineering approach as a basis for the safe and efficient clinical translation of TEHVs.
在以往研究的基础上，这些工作表明了硅胶，体外和体内的生物工程整体方法的相关性，为找到安全而临床有效的TEHV移植物奠定了基础。
Computational modeling guides tissue-engineered heart valve design for long-term in vivo performance in a translational sheep model，
Maximilian Y. Emmert，Boris A. Schmitt，et. al.
Science Translational Medicine 09 May 2018:
Vol. 10, Issue 440, eaan4587
DOI: 10.1126/scitranslmed.aan4587
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