Di Franco Sveva, Amarelli Cristiano, Montalto Andrea, Loforte Antonio, Musumeci Francesco
Department of Anaesthesiology and Critical Care Medicine, L. Vanvitelli University, Naples, Italy.
Department of Cardiovascular Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy.
J Thorac Dis. 2018 Jul;10(Suppl 20):S2346-S2362. doi: 10.21037/jtd.2018.01.85.
Regenerative medicine is an emerging interdisciplinary field of scientific research that, supported by tissue engineering is, nowadays, a valuable and reliable solution dealing with the actual organs shortage and the unresolved limits of biological or prosthetic materials used in repair and replacement of diseased or damaged human tissues and organs. Due to the improvements in design and materials, and to the changing of clinical features of patients treated for valvular heart disease the distance between the ideal valve and the available prostheses has been shortened. We will then deal with the developing of new tools aiming at replacing or repair cardiac tissues that still represent an unmet clinical need for the surgeons and indeed for their patients. In the effort of improving treatment for the cardiovascular disease (CVD), scientists struggle with the lack of self-regenerative capacities of finally differentiated cardiovascular tissues. In this context, using several converging technological approaches, regenerative medicine moves beyond traditional transplantation and replacement therapies and can restore tissue impaired function. It may also play an essential role in surgery daily routine, leading to produce devices such as injectable hydrogels, cardiac patches, bioresorbable stents and vascular grafts made by increasingly sophisticated biomaterial scaffolds; tailored devices promptly fabricated according to surgeon necessity and patient anatomy and pathology will hopefully represent a daily activity in the next future. The employment of these devices, still far from the reproduction of functional organs, has the main aim to achieve a self-renewal process in damaged tissues simulating endogenous resident cell populations. In this field, the collaboration and cooperation between cardiothoracic surgeons and bioengineers appear necessary to modify these innovative devices employed in preclinical studies according to the surgeon's needs.
再生医学是一个新兴的跨学科科研领域，在组织工程学的支持下，如今已成为解决实际器官短缺问题以及修复和替换患病或受损人体组织及器官时所使用的生物材料或假体材料存在的未解决局限性的一种有价值且可靠的解决方案。由于设计和材料的改进，以及接受心脏瓣膜疾病治疗的患者临床特征的变化，理想瓣膜与现有假体之间的差距已缩短。接下来，我们将探讨旨在替换或修复心脏组织的新工具的开发，这对于外科医生及其患者来说仍是未满足的临床需求。在努力改善心血管疾病（CVD）治疗的过程中，科学家们面临着终末分化的心血管组织缺乏自我再生能力的问题。在这种背景下，再生医学通过多种融合的技术方法，超越了传统的移植和替代疗法，能够恢复受损组织的功能。它在日常手术中也可能发挥重要作用，促使生产出诸如可注射水凝胶、心脏补片、生物可吸收支架以及由日益复杂的生物材料支架制成的血管移植物等装置；根据外科医生的需求和患者的解剖结构及病理情况迅速定制的装置有望在不久的将来成为日常操作。这些装置的应用虽然离功能性器官的复制还相差甚远，但其主要目的是在受损组织中模拟内源性驻留细胞群实现自我更新过程。在这个领域，心胸外科医生和生物工程师之间的合作显得很有必要，以便根据外科医生的需求对临床前研究中使用的这些创新装置进行改进。
