Polysaccharides, as biological macromolecule-based scaffolding systems in heart valve tissue engineering: a review

Valvular heart disease is a major clinical challenge with significant morbidity and mortality rate. Generally, valve repair is advantageous over replacement, however most of these valves are impossible to repair. Donor shortage has resulted in long waiting lists, and the need for heart valve replacement is estimated to triple in the coming years. In addition, the use of mechanical and bioprosthetic heart valves is associated with several challenges such as thrombogenicity, short durability, and the need for repeated surgeries for valve replacement. Heart valve tissue engineering (HVTE) has recently offered new solutions to address these shortcomings. In this endeavour, material selection and optimization are of vital importance. Among different scaffolding biomaterials, the appeal of polysaccharides in HVTE is on the rise. Due to their excellent biocompatibility, tailorable properties, low cost, and availability, these biomaterials have been widely explored as scaffolding systems for HVTE. The current review will discuss applications, challenges, and future perspectives of these biomaterials in HVTE. Graphical abstract