Dohmen Pascal M, Konertz Wolfgang
Department of Cardiovascular Surgery, Charité Hospital, Medical University Berlin, Berlin, Germany.
Ann Thorac Cardiovasc Surg. 2009 Dec;15(6):362-7.
Since the first heterotopic implanted biological heart valve in 1956 by Murray, many improvements have been made. For allografts, different methods have been evaluated and modified to stabilize and preserve tissue. Xenografts were fixated to cross-link the connective tissue and to overcome immunogenic reactions. Nevertheless, glutaraldehyde fixation leads to structural deterioration, which can be partially reduced by different kinds of antimineralization treatments. Because of preservation and fixation, allografts and xenografts become nonviable bioprostheses with a lack of remodeling, regeneration, and growth. Tissue engineering is a possible key to overcome these disadvantages because it will provide a living tissue with remodeling, regeneration, and growth potential. This overview will issue the key points to provide such a tissue-engineered heart valve by creating a sufficient scaffold where cells can grow, either in vitro or in vivo, and remodel a neoscaffold that will lead to a functional autologous heart valve.
自1956年默里首次进行异位植入生物心脏瓣膜以来,已经取得了许多改进。对于同种异体移植物,人们评估并改进了不同方法以稳定和保存组织。对于异种移植物,通过交联结缔组织来固定,以克服免疫原性反应。然而,戊二醛固定会导致结构恶化,不同种类的抗矿化处理可部分降低这种恶化。由于保存和固定,同种异体移植物和异种移植物成为缺乏重塑、再生和生长能力的无活力生物假体。组织工程可能是克服这些缺点的关键,因为它将提供具有重塑、再生和生长潜力的活组织。本综述将阐述通过创建一个足够的支架来提供这种组织工程心脏瓣膜的关键点,细胞可以在该支架上体外或体内生长,并重塑一个新支架,从而形成功能性自体心脏瓣膜。