Section of Pediatric Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC.
Surgery. 2021 Apr;169(4):983-985. doi: 10.1016/j.surg.2020.07.051. Epub 2020 Sep 15.
Children undergoing congenital cardiac surgery often outgrow the valve implants. These children are thus committed to morbid reoperations for successive exchanges of the vavular implants that they have outgrown. Therefore the holy grail of congenital cardiac surgery is a valve implant that grows with the recipient child. Preserved homografts routinely are used as valve implants, but they do not grow as the child grows because they lose viability during preservation. In contrast, pulmonary autografts and pediatric heart transplants grow with the recipient children. Similarly, partial heart transplantation can deliver growing valve implants for congenital cardiac surgery. Temporary immune suppression would only be needed until the partial heart transplant can be exchanged for an adult-sized prosthetic valve in the grown child.
接受先天性心脏手术的儿童往往会随着身体的成长而使植入的瓣膜不再适用。这些儿童需要反复进行手术，以更换已长大的瓣膜植入物。因此，先天性心脏手术的圣杯是一种能随着受者儿童生长的瓣膜植入物。同种异体保存移植物通常被用作瓣膜植入物，但它们不会随着儿童的生长而生长，因为在保存过程中它们会失去活力。相比之下，肺动脉和儿童心脏移植会随着受者儿童一起生长。同样，部分心脏移植可以为先天性心脏手术提供不断生长的瓣膜植入物。在部分心脏移植可以被成年大小的人工瓣膜取代之前，只需要暂时的免疫抑制。
