Mantakaki Antonia, Fakoya Adegbenro Omotuyi John, Sharifpanah Fatemeh
Surgical Division, Teleflex Incorporated, Bristol, United Kingdom.
Department of Anatomical Sciences, University of Medicine and Health Sciences, Basseterre, St. Kitts and Nevis.
PeerJ. 2018 Oct 25;6:e5805. doi: 10.7717/peerj.5805. eCollection 2018.
Congenital heart disease (CHD) affects a considerable number of children and adults worldwide. This implicates not only developmental disorders, high mortality, and reduced quality of life but also, high costs for the healthcare systems. CHD refers to a variety of heart and vascular malformations which could be very challenging to reconstruct the malformed region surgically, especially when the patient is an infant or a child. Advanced technology and research have offered a better mechanistic insight on the impact of CHD in the heart and vascular system of infants, children, and adults and identified potential therapeutic solutions. Many artificial materials and devices have been used for cardiovascular surgery. Surgeons and the medical industry created and evolved the ball valves to the carbon-based leaflet valves and introduced bioprosthesis as an alternative. However, with research further progressing, contracting tissue has been developed in laboratories and tissue engineering (TE) could represent a revolutionary answer for CHD surgery. Development of engineered tissue for cardiac and aortic reconstruction for developing bodies of infants and children can be very challenging. Nevertheless, using acellular scaffolds, allograft, xenografts, and autografts is already very common. Seeding of cells on surface and within scaffold is a key challenging factor for use of the above. The use of different types of stem cells has been investigated and proven to be suitable for tissue engineering. They are the most promising source of cells for heart reconstruction in a developing body, even for adults. Some stem cell types are more effective than others, with some disadvantages which may be eliminated in the future.
先天性心脏病（CHD）在全球影响着相当数量的儿童和成人。这不仅意味着发育障碍、高死亡率和生活质量下降，还意味着医疗系统的高成本。CHD指的是多种心脏和血管畸形，对这些畸形区域进行手术重建可能极具挑战性，尤其是当患者为婴儿或儿童时。先进的技术和研究为CHD对婴儿、儿童及成人心脏和血管系统的影响提供了更好的机制性见解，并确定了潜在的治疗方案。许多人工材料和装置已用于心血管手术。外科医生和医疗行业将球瓣发展到碳基瓣叶瓣膜，并引入生物假体作为替代方案。然而，随着研究的进一步推进，实验室已研发出收缩组织，组织工程（TE）可能为CHD手术带来革命性的解决方案。为婴儿和儿童发育中的身体构建用于心脏和主动脉重建的工程组织可能极具挑战性。尽管如此，使用脱细胞支架、同种异体移植物、异种移植物和自体移植物已经非常普遍。在支架表面和内部接种细胞是使用上述材料的一个关键挑战因素。不同类型干细胞的使用已得到研究，并被证明适用于组织工程。它们是发育中身体甚至成人心脏重建最有前景的细胞来源。某些干细胞类型比其他类型更有效，同时也存在一些缺点，这些缺点未来可能会被消除。
