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Ross手术中用于肺动脉瓣置换的基质P脱细胞异种移植物的血流动力学特征

Hemodynamic characteristics of the Matrix P decellularized xenograft for pulmonary valve replacement during the Ross operation.

作者信息

Konertz Wolfgang, Dohmen Pascal M, Liu Jianshi, Beholz Sven, Dushe Simon, Posner Steffen, Lembcke Alexander, Erdbrügger Wilhelm

机构信息

Charité Universitätsmedizin Berlin, Department of Cardiovascular Surgery, Berlin, Germany.

出版信息

J Heart Valve Dis. 2005 Jan;14(1):78-81.

Abstract

BACKGROUND AND AIM OF THE STUDY

Aortic valve disease can be treated successfully by means of the Ross operation. Alternatives to pulmonary valve replacement with homografts are needed. The study aim was to demonstrate the performance of a decellularized porcine xenograft valve (Matrix P) in adult patients after the Ross operation.

METHODS

Between July 2002 and May 2004, a total of 50 Ross operations was performed with the Matrix P for pulmonary valve replacement. Operative results and postoperative hemodynamics were evaluated.

RESULTS

The median patient age was 46 years (range: 17-70 years). Among patients, 36% underwent additional procedures, most often repair of aneurysms of the ascending aorta or coronary artery bypass grafts. One patient died from septic multiorgan failure on postoperative day 36. One reoperation on the Matrix P and one reoperation on the aortic valve were necessary; both reoperations were uneventful. Postoperative echocardiography demonstrated low transvalvular gradients that did not tend to increase over time.

CONCLUSION

In contrast to homografts and other xenografts the Matrix P decellularized xenograft showed, postoperatively, no rise in right ventricular-pulmonary artery pressure gradients. Indeed, the valve was seen to behave similarly to a physiologically normal valve in a healthy subject.

摘要

研究背景与目的

主动脉瓣疾病可通过罗斯手术成功治疗。需要同种异体移植物替代肺动脉瓣置换的替代方法。本研究的目的是证明脱细胞猪异种移植瓣膜(Matrix P)在罗斯手术后成年患者中的性能。

方法

2002年7月至2004年5月期间,共进行了50例使用Matrix P进行肺动脉瓣置换的罗斯手术。评估手术结果和术后血流动力学。

结果

患者的中位年龄为46岁(范围:17 - 70岁)。在患者中,36%接受了额外的手术,最常见的是升主动脉瘤修复或冠状动脉搭桥术。1例患者在术后第36天死于感染性多器官功能衰竭。需要对Matrix P进行1次再次手术和对主动脉瓣进行1次再次手术;两次再次手术均顺利。术后超声心动图显示跨瓣膜压差较低,且未随时间推移而升高。

结论

与同种异体移植物和其他异种移植物相比,脱细胞异种移植瓣膜Matrix P术后右心室 - 肺动脉压力梯度没有升高。实际上,该瓣膜的表现与健康受试者生理上正常的瓣膜相似。

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