Knirsch Walter, Krüger Bernard, Fleischmann Thea, Malbon Alexandra, Lipiski Miriam, Lemme Frithjof, Sauer Mareike, Cesarovic Niko, Dave Hitendu, Hübler Michael, Schweiger Martin
Division of Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland.
Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
J Thorac Dis. 2020 Mar;12(3):1070-1078. doi: 10.21037/jtd.2019.12.70.
Many valvular pathologies of the heart may be only sufficiently treated by replacement of the valve if a reconstruction is not feasible. However, structural deterioration, thrombosis with thromboembolic events and infective endocarditis are commonly encountered complications over time and often demand a re-operation. In congenital heart disease the lack of small diameter valves with the potential to grow poses additional challenges and limits treatment options to homo- or xenograft implants.
In this study, a chronic sheep model (24 months follow-up), a self-constructed valved conduit was created out of a tissue engineered (TE) patch (CorMatrix® Cardiovascular, Inc, USA) and implanted in orthotopic right ventricular (RV)-pulmonary artery (PA) position. Thereafter, the sheep were regularly monitored by clinical, laboratory and echocardiographic examinations to evaluate cardiac function and the implanted RV-PA-conduit.
Here, we summarize the study protocol and our experiences during the perioperative phase and the follow up period and explain how we constructed a valved conduit out of a commercially available TE patch.
License number: ZH 284/14.
如果瓣膜重建不可行,许多心脏瓣膜病变可能只能通过瓣膜置换来充分治疗。然而,随着时间的推移,结构恶化、血栓形成伴血栓栓塞事件以及感染性心内膜炎是常见的并发症,并且常常需要再次手术。在先天性心脏病中,缺乏具有生长潜力的小直径瓣膜带来了额外的挑战,并将治疗选择限制为同种或异种移植植入物。
在本研究中,建立了一个慢性绵羊模型(随访24个月),用组织工程(TE)补片(美国CorMatrix®心血管公司)自制带瓣管道,并将其植入原位右心室(RV)-肺动脉(PA)位置。此后,定期通过临床、实验室和超声心动图检查对绵羊进行监测,以评估心脏功能和植入的RV-PA管道。
在此,我们总结了研究方案以及围手术期和随访期间的经验,并解释了我们如何用市售的TE补片构建带瓣管道。
许可证号:ZH 284/14。