{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:29:48Z","timestamp":1771399788992,"version":"3.50.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite fundamental improvements in surgical treatment of Congenital Heart Defects, there are still challenges related to premature failure of the material used for such corrections, thus resulting in repeated operations during a patient\u2019s life. This is particularly the case for complex defects with Right Ventricular Outflow Tract (RVOT) obstruction, such as in Tetralogy of Fallot\/Pulmonary Atresia, whereby the pulmonary valve reconstruction remains problematic due to short-term durability of the currently used replacement solutions. We set out to test, for the first time, the suitability of amniotic membrane derived from human placenta for use in cardiovascular replacement of pulmonary valve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The decellularized and preserved amniotic membrane, obtained through our optimised protocol, was characterised for mechanical and hydrodynamic properties\n                      <jats:italic>in vitro<\/jats:italic>\n                      , and then implanted in the RVOT position of two Landrace piglets for\n                      <jats:italic>in vivo<\/jats:italic>\n                      feasibility and performance evaluation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both the\n                      <jats:italic>in vitro<\/jats:italic>\n                      and\n                      <jats:italic>in vivo<\/jats:italic>\n                      assessments showed favourable outcomes. The decellularized amniotic membrane had mechanical properties comparable to the native porcine pulmonary valve leaflets. In hydrodynamic testing, the decellularized amniotic membrane-made valve exhibited favourable opening dynamics, with smooth and coordinated leaflet motion throughout the cycle.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , the decellularized amniotic membrane-based valved conduit showed patency in the short- and long-term with no sign of stenosis or regurgitation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      This study provides an\n                      <jats:italic>in vivo<\/jats:italic>\n                      proof of concept that the decellularized amniotic membrane can be implanted and perform as functional pulmonary valve in a porcine animal model mimicking the clinical scenario of Tetralogy of Fallot surgical correction in infants.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1735821","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:55:35Z","timestamp":1771397735000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The use of human decellularized amniotic membrane as pulmonary valve leaflets in right ventricular outflow tract reconstruction \u2013 an in vivo proof of concept study"],"prefix":"10.3389","volume":"14","author":[{"given":"Mohamed T.","family":"Ghorbel","sequence":"first","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasneem","family":"Salih","sequence":"additional","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Parolari","sequence":"additional","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]},{"name":"Department of Cardiac Surgery, Bristol Royal Hospital for Children","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie L.","family":"Skeffington","sequence":"additional","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Di Leonardo","sequence":"additional","affiliation":[{"name":"Ri.MED Foundation","place":["Palermo, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danila","family":"Vella","sequence":"additional","affiliation":[{"name":"Ri.MED Foundation","place":["Palermo, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Burriesci","sequence":"additional","affiliation":[{"name":"Ri.MED Foundation","place":["Palermo, Italy"]},{"name":"Deptartment of Engineering, University of Palermo","place":["Palermo, Italy"]},{"name":"UCL Mechanical Engineering, University College London","place":["London, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Caputo","sequence":"additional","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]},{"name":"Department of Cardiac Surgery, Bristol Royal Hospital for Children","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominga","family":"Iacobazzi","sequence":"additional","affiliation":[{"name":"Translational Health Sciences, University of Bristol","place":["Bristol, United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"101212","DOI":"10.1016\/j.cpcardiol.2022.101212","article-title":"Pulmonary valve replacement: a new paradigm with tissue engineering","volume":"48","author":"Almeida-Pinto","year":"2023","journal-title":"Curr. 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