Skidmore Savannah, Hill Morgan A, Bishara Katherine, Konsek Haley, Kwon Jennie H, Brockbank Kelvin G M, Rajab Taufiek Konrad
College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
J Cardiovasc Dev Dis. 2023 May 26;10(6):234. doi: 10.3390/jcdd10060234.
Unrepairable congenital heart valve disease is an unsolved problem in pediatric cardiac surgery because there are no growing heart valve implants. Partial heart transplantation is a new type of transplant that aims to solve this problem. In order to study the unique transplant biology of partial heart transplantation, animal models are necessary. This study aimed to assess the morbidity and mortality of heterotopic partial heart transplantation in rodent models. This study assessed two models. The first model involved transplanting heart valves from donor animals into the abdominal aortic position in the recipient animals. The second model involved transplanting heart valve leaflets into the renal subcapsular position of the recipient animals. A total of 33 animals underwent heterotopic partial heart transplantation in the abdominal aortic position. The results of this model found a 60.61% ( = 20/33) intraoperative mortality rate and a 39.39% ( = 13/33) perioperative mortality rate. Intraoperative mortality was due to vascular complications from the procedure, and perioperative mortality was due to graft thrombosis. A total of 33 animals underwent heterotopic partial heart transplantation in the renal subcapsular position. The results of this model found a 3.03% ( = 1/33) intraoperative mortality rate, and the remaining 96.97% survived ( = 32/33). We conclude that the renal subcapsular model has a lower mortality rate and is technically more accessible than the abdominal aortic model. While the heterotopic transplantation of valves into the abdominal aortic position had significant morbidity and mortality in the rodent model, the renal subcapsular model provided evidence for successful heterotopic transplantation.
不可修复的先天性心脏瓣膜疾病是小儿心脏外科领域一个尚未解决的问题，因为目前尚无能够随心脏生长的瓣膜植入物。部分心脏移植是一种旨在解决这一问题的新型移植方式。为了研究部分心脏移植独特的移植生物学特性，动物模型是必不可少的。本研究旨在评估啮齿动物模型中异位部分心脏移植的发病率和死亡率。本研究评估了两种模型。第一种模型是将供体动物的心脏瓣膜移植到受体动物的腹主动脉位置。第二种模型是将心脏瓣膜小叶移植到受体动物的肾被膜下位置。共有33只动物接受了腹主动脉位置的异位部分心脏移植。该模型的结果显示术中死亡率为60.61%（=20/33），围手术期死亡率为39.39%（=13/33）。术中死亡是由于手术过程中的血管并发症，围手术期死亡是由于移植物血栓形成。共有33只动物接受了肾被膜下位置的异位部分心脏移植。该模型的结果显示术中死亡率为3.03%（=1/33），其余96.97%存活（=32/33）。我们得出结论，肾被膜下模型的死亡率较低，且在技术上比腹主动脉模型更容易操作。虽然在啮齿动物模型中，将瓣膜异位移植到腹主动脉位置有显著的发病率和死亡率，但肾被膜下模型为成功的异位移植提供了证据。
