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肺动脉成形术治疗体内组织工程血管移植物的中期结果。

Midterm results of pulmonary artery plasty with in vivo tissue-engineered vascular grafts.

机构信息

Department of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Division of Cardiovascular Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2021 May 27;32(6):956-959. doi: 10.1093/icvts/ivab019.

Abstract

UNLABELLED

We evaluated the application of in vivo tissue-engineered vascular graft (in vivo TEVG) in pulmonary artery (PA) reconstruction as a substitute for autologous pericardium. From July 2017 to April 2020, 4 patients (male:female = 2:2) with major aortopulmonary collateral arteries underwent PA reconstruction with in vivo TEVGs. Graft moulds were embedded into the subcutaneous spaces in the first palliative surgery. In the second surgery used in vivo TEVGs were used as patch materials to treat PA stenosis. Preoperative and postoperative PA configurations were evaluated by computed tomography. Patients' median age and body weight were 1.6 (1-4) years and 8.7 (7.3-15.4) kg, respectively. Two patients underwent PA reconstruction during staged repair and 2 underwent reconstruction during definitive repair. One patient had postoperative PA restenosis due to bronchial compression; re-PA reconstruction with in vivo TEVGs was performed. On histological examination, the in vivo TEVG wall mainly comprised collagen fibres and a small number of fibroblasts. The midterm results of this technique are satisfactory. in vivo TEVGs could be a promising alternative to autologous pericardium for paediatric cardiovascular surgeries requiring multi-stage operations.

CLINICAL TRIAL REGISTRATION

ERB-C-162.

摘要

目的

评估将体内组织工程血管移植物(in vivo TEVG)应用于肺动脉(PA)重建作为自体心包的替代品。

方法

从 2017 年 7 月至 2020 年 4 月,4 例(男:女=2:2)伴有主肺动脉侧支的患者接受了体内 TEVG 进行 PA 重建。移植物模具在第一次姑息性手术中被嵌入皮下空间。在第二次手术中,使用体内 TEVGs 作为补丁材料来治疗 PA 狭窄。通过计算机断层扫描评估术前和术后的 PA 形态。患者的中位年龄和体重分别为 1.6(1-4)岁和 8.7(7.3-15.4)kg。2 例患者在分期修复期间进行了 PA 重建,2 例患者在确定性修复期间进行了重建。1 例患者因支气管压迫导致术后 PA 再狭窄,再次采用体内 TEVGs 进行 PA 重建。组织学检查显示,体内 TEVG 壁主要由胶原纤维和少量成纤维细胞组成。该技术的中期结果令人满意。体内 TEVGs 可能成为小儿心血管手术中多阶段手术中自体心包的有前途的替代品。

临床试验注册号

ERB-C-162。

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本文引用的文献

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Histology and Mechanics of In Vivo Tissue-Engineered Vascular Graft for Children.体内组织工程血管移植物的组织学和力学。
Ann Thorac Surg. 2020 Sep;110(3):1050-1054. doi: 10.1016/j.athoracsur.2020.03.069. Epub 2020 Apr 28.
5
Readily available tissue-engineered vascular grafts.现成的组织工程血管移植物。
Sci Transl Med. 2011 Feb 2;3(68):68ra9. doi: 10.1126/scitranslmed.3001426.
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Reconstruction of the pulmonary artery.肺动脉重建术。
Semin Thorac Cardiovasc Surg. 2006 Summer;18(2):104-8. doi: 10.1053/j.semtcvs.2006.05.004.

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