Medical College, Qingdao University, Qingdao, China.
Qingdao Women and Children's Hospital, QingdaoUniversity, Qingdao, China.
J Biomed Mater Res B Appl Biomater. 2024 Jan;112(1):e35351. doi: 10.1002/jbm.b.35351. Epub 2023 Nov 16.
Cardiac septal defect is the most prevalent congenital heart disease and is typically treated with open-heart surgery under cardiopulmonary bypass. Since the 1990s, with the advancement of interventional techniques and minimally invasive transthoracic closure techniques, cardiac occluder implantation represented by the Amplazter products has been the preferred treatment option. Currently, most occlusion devices used in clinical settings are primarily composed of Nitinol as the skeleton. Nevertheless, long-term follow-up studies have revealed various complications related to metal skeletons, including hemolysis, thrombus, metal allergy, cardiac erosion, and even severe atrioventricular block. Thus, occlusion devices made of biodegradable materials have become the focus of research. Over the past two decades, several bioabsorbable cardiac occluders for ventricular septal defect and atrial septal defect have been designed and trialed on animals or humans. This review summarizes the research progress of bioabsorbable cardiac occluders, the advantages and disadvantages of different biodegradable polymers used to fabricate occluders, and discusses future research directions concerning the structures and materials of bioabsorbable cardiac occluders.
先天性心脏病中最常见的是房间隔缺损，通常采用体外循环下心内直视手术治疗。自 20 世纪 90 年代以来，随着介入技术和微创经胸封堵技术的进步，以 Amplazter 产品为代表的心脏封堵器植入已成为首选的治疗选择。目前，临床应用的大多数封堵装置主要由 Nitinol 作为骨架。然而，长期随访研究发现金属骨架存在多种并发症，包括溶血、血栓形成、金属过敏、心脏侵蚀，甚至严重的房室传导阻滞。因此，可生物降解材料的封堵装置已成为研究的焦点。在过去的二十年中，已经设计并在动物或人体上试验了几种用于室间隔缺损和房间隔缺损的生物可吸收心脏封堵器。本文综述了生物可吸收心脏封堵器的研究进展，不同用于制造封堵器的可生物降解聚合物的优缺点，并讨论了生物可吸收心脏封堵器的结构和材料的未来研究方向。
