Dynamically-Loaded 3-D Model to Study the ECM Organization of Aortic Smooth Muscle Cells in Aneurysmal Patients With Bicuspid Aortic Valve

Rupture of aortic aneurysms and dissections are the fifteenth leading cause of a death in the United States [1]. Over 40% of patients undergoing elective surgery for ascending aortic replacement due to thoracic aortic aneurysm (TAA) have a congenital defect in the aortic valve know as bicuspid aortic valve (BAV) [2]. BAV patients have uniformly larger diameter aortic roots and ascending aortas compared to age- and sex-matched controls [3] and abnormal elasticity even in the absence of valvular stenosis or aneurysm [4] and this greatly increases the risk of aortic dissection and sudden death [5]. The cause of TAA is uncertain, but recent studies suggest that oxidative stress may play a role in the pathogenesis of TAAs by degrading the extracellular matrix (ECM). We identified that BAV smooth muscle cells (SMCs) lack sufficient resistance to reactive oxygen species to maintain ECM homeostasis [6, 7].