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心脏瓣膜置换疗法的当前进展与未来前景

Current developments and future prospects for heart valve replacement therapy.

作者信息

Kidane Asmeret G, Burriesci Gaetano, Cornejo Patricia, Dooley Audrey, Sarkar Sandip, Bonhoeffer Philipp, Edirisinghe Mohan, Seifalian Alexander M

机构信息

Biomaterial and Tissue Engineering Centre (BTEC), Academic Division of Surgery & Interventional Sciences, University College London, London, United Kingdom.

出版信息

J Biomed Mater Res B Appl Biomater. 2009 Jan;88(1):290-303. doi: 10.1002/jbm.b.31151.

Abstract

Valve replacement is the most common surgical treatment in patients with advanced valvular heart disease. Mechanical and bio-prostheses have been the traditional heart valve replacements in these patients. However, currently the heart valves for replacement therapy are imperfect and subject patients to one or more ongoing risks, including thrombosis, limited durability, and need for re-operations due to the lack of growth in pediatric populations. Furthermore, they require an open heart surgery, which is risky for elderly and young children who are too weak or ill to undergo major surgery. This article reviews the current state of the art of heart valve replacements in light of their potential clinical applications. In recent years polymeric materials have been widely studied as potential prosthetic heart valve material being designed to overcome the clinical problems associated with both mechanical and bio-prosthetic valves. The review also addresses the advances in polymer materials, tissue engineering approaches, and the development of percutaneous valve replacement technology and discusses the future prospects in these fields.

摘要

瓣膜置换是晚期瓣膜性心脏病患者最常见的外科治疗方法。机械瓣膜和生物瓣膜一直是这些患者传统的心脏瓣膜置换物。然而,目前用于置换治疗的心脏瓣膜并不完美,会使患者面临一种或多种持续存在的风险,包括血栓形成、耐久性有限以及由于儿科人群缺乏生长而需要再次手术。此外,它们需要进行心脏直视手术,这对于身体过于虚弱或患病而无法接受大手术的老年人和幼儿来说风险很大。本文根据心脏瓣膜置换的潜在临床应用,综述了其当前的技术水平。近年来,聚合物材料作为潜在的人工心脏瓣膜材料受到了广泛研究,旨在克服与机械瓣膜和生物瓣膜相关的临床问题。该综述还讨论了聚合物材料、组织工程方法的进展以及经皮瓣膜置换技术的发展,并探讨了这些领域的未来前景。

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