Gómez-Ullate J M, Reyes I, Malo P, Arriaga F, Caffarena J M
Sección de Cirugía Cardíaca Pediátrica, Hospital Infantil La Fe, Valencia.
Rev Esp Cardiol. 1992 Mar;45(3):188-92.
In recent years the use of cryopreserved allograft valves has become very popular. Homograft valves have been used for aortic valve replacement and for reconstruction of the outflow tract of the right ventricle for more than 30 years with very good results. Recently the method of cryopreservation has made possible the creation of valve banks. The use of this cryopreserved valves has obtained very good short and medium term results. We present our experience with the use of cryopreserved allograft valves in the reconstruction of the right ventricular outflow tract in the treatment of complex cardiac malformations. We have operated 15 children. Six were diagnosed of different types of transpositions of the great arteries with ventricular septal defect and pulmonary atresia or stenosis. There were 2 deaths not related to the use of the allograft valves. Nine other patients were diagnosed of different types of complex cardiac malformations. One patient with a univentricular heart and pulmonary stenosis and a neonate presenting with a truncus arteriosus communis died after the operation; again the deaths were not related to the use of the homograft conduits. Our technique of cryopreservation consists in the procurement of aortic and pulmonary valves from multiorgan donor patients. The valves are sterilized in antibiotics for 48 hours. Then the process of freezing is began with a period of progressive cooling down to -40 degrees C and second phase of storage in liquid nitrogen to a temperature of -178 degrees C. The short and medium term results are very satisfactory. We have not seen late important complications.
近年来，冷冻保存同种异体瓣膜的应用变得非常普遍。同种异体瓣膜用于主动脉瓣置换和右心室流出道重建已有30多年，效果非常好。最近，冷冻保存方法使得建立瓣膜库成为可能。使用这种冷冻保存的瓣膜已取得了非常好的短期和中期效果。我们介绍我们在使用冷冻保存同种异体瓣膜重建右心室流出道治疗复杂心脏畸形方面的经验。我们为15名儿童进行了手术。6名被诊断为不同类型的大动脉转位合并室间隔缺损和肺动脉闭锁或狭窄。有2例死亡与同种异体瓣膜的使用无关。另外9名患者被诊断为不同类型的复杂心脏畸形。1例单心室心脏合并肺动脉狭窄的患者和1例新生儿共同动脉干患者术后死亡；同样，死亡与同种异体管道的使用无关。我们的冷冻保存技术包括从多器官供体患者获取主动脉瓣和肺动脉瓣。瓣膜在抗生素中消毒48小时。然后开始冷冻过程，先进行逐步降温至-40℃的阶段，第二阶段在液氮中储存至-178℃。短期和中期效果非常令人满意。我们尚未见到晚期重要并发症。
