Ichikawa Y, Noishiki Y, Kosuge T, Yamamoto K, Kondo J, Matsumoto A
First Department of Surgery, Yokohama City University School of Medicine, Japan.
J Thorac Cardiovasc Surg. 1997 Aug;114(2):224-33. doi: 10.1016/S0022-5223(97)70149-1.
We evaluated a bovine jugular vein graft with a natural trileaflet valve for right ventricular outflow tract reconstruction in a canine study for an entire year.
Heparinized bovine jugular vein grafts with a natural valve cross-linked with a hydrophilic polyepoxy compound of 18 to 20 mm in internal diameter were implanted in the right ventricular-pulmonary arterial position in eight dogs, and the main natural pulmonary artery was ligated. Anticoagulants were not used after implantation. Five grafts were retrieved on day 182 after implantation and the other three grafts on days 196, 375, and 385, respectively, and were inspected by macroscopic and microscopic observation. Cardiac catheterization, followed by angiography and echocardiography, was done just before graft retrieval.
No graft kinking or regurgitation of the valve was observed. Echocardiography showed natural valve motion without thickening of the leaflets. Blood pressure in the conduits ranged from 18/9 to 31/4 mm Hg, in the right ventricle from 18/4 to 40/0 mm Hg, and the gradient varied from 0 to 14 mm Hg. The explanted conduits maintained their original shape, softness, and pliability with good coaptation of valves, without calcification or degenerative changes, except for one leaflet with slight deformation. In microscopic observation, endothelial cells lined the luminal surface of the conduit except for the areas adjacent to the valve.
The graft worked perfectly as a right ventricular-pulmonary arterial valved conduit without anticoagulant therapy for a long time.
在一项为期一整年的犬类研究中，我们评估了一种带有天然三叶瓣的牛颈静脉移植物用于右心室流出道重建的情况。
将内径为18至20毫米、带有与亲水性聚环氧化合物交联的天然瓣膜的肝素化牛颈静脉移植物植入8只犬的右心室 - 肺动脉位置，并结扎主要天然肺动脉。植入后未使用抗凝剂。分别在植入后第182天取出5个移植物，另外3个移植物分别在第196、375和385天取出，并进行宏观和微观观察。在取出移植物前进行心脏导管检查，随后进行血管造影和超声心动图检查。
未观察到移植物扭结或瓣膜反流。超声心动图显示天然瓣膜活动，瓣叶无增厚。导管内血压范围为18/9至31/4毫米汞柱，右心室内血压范围为18/4至40/0毫米汞柱，压差为0至14毫米汞柱。取出的导管保持其原始形状、柔软度和柔韧性，瓣膜贴合良好，除一个瓣叶有轻微变形外，无钙化或退行性改变。在微观观察中，除了与瓣膜相邻的区域外，导管腔表面衬有内皮细胞。
该移植物作为右心室 - 肺动脉带瓣导管，在无需抗凝治疗的情况下长期完美发挥作用。
