Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, USA.
Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC, USA.
J Cardiothorac Surg. 2021 Dec 28;16(1):358. doi: 10.1186/s13019-021-01743-0.
Heart valve replacement in neonates and infants is one of the remaining unsolved problems in cardiac surgery because conventional valve prostheses do not grow with the children. Similarly, heart valve replacement in children and young adults with contraindications to anticoagulation remains an unsolved problem because mechanical valves are thrombogenic and bioprosthetic valves are prone to early degeneration. Therefore, there is an urgent clinical need for growing heart valve replacements that are durable without the need for anticoagulation.
A human cadaver model was used to develop surgical techniques for aortic valve xenotransplantation.
Aortic valve xenotransplantation is technically feasible. Subcoronary implantation of the valve avoids the need for a root replacement.
Aortic valve xenotransplantation is promising because the development of GTKO.hCD46.hTBM transgenic pigs has brought xenotransplantation within clinical reach.
新生儿和婴儿的心脏瓣膜置换仍然是心脏外科领域尚未解决的难题之一，因为传统的瓣膜假体不能随儿童的生长而生长。同样，对于不能抗凝的儿童和青年人群进行心脏瓣膜置换仍然是一个尚未解决的问题，因为机械瓣膜具有血栓形成倾向，生物瓣容易早期退化。因此，临床上迫切需要能够随着心脏生长而生长的、耐用且无需抗凝的心脏瓣膜置换物。
使用人体尸体模型开发了主动脉瓣异种移植的手术技术。
主动脉瓣异种移植在技术上是可行的。瓣膜的冠状动脉下植入避免了根部置换的需要。
主动脉瓣异种移植很有前景，因为 GTKO.hCD46.hTBM 转基因猪的发展使异种移植成为可能。
