Strain-based optimization of human tissue-engineered small diameter blood vessels

Coronary arteries originate from the root of the aorta and supply blood to the heart. These arteries can become stiffer and narrowed due to the buildup of atherosclerotic plaque in the inner vessel layers. As the plaque increases in size, the lumen of the coronary arteries decreases and less blood can flow through them. Eventually, coronary artery disease (CAD) can lead to chest pain or a myocardial infarction. Treatment for this disease includes medicines, minimally invasive interventional procedures such as angioplasty and stent implantation, and coronary artery bypass grafting (CABG). Today most CABG operations are performed using combinations of the autologous left internal mammary artery and the saphenous vein. These grafts, especially the latter, perform suboptimal. In addition, a relative large part of all patients do not have suitable veins or arteries, caused by disease of the replacement vessel itself, usage in previous surgeries, the need for multiple bypasses or a combination of all these factors. Therefore, other types of vascular grafts have been proposed to replace the native substitute. Synthetic grafts, such ePTFE and Dacron, perform well at diameters >6mm, but are not suitable for small-diameter (