Schoof P H, Hazekamp M G, van Wermeskerken G K, de Heer E, Bruijn J A, Gittenberger-de Groot A C, Huysmans H A
Department of Cardiothoracic Surgery, University Hospital Leiden, The Netherlands.
J Thorac Cardiovasc Surg. 1998 Jun;115(6):1264-72. doi: 10.1016/s0022-5223(98)70208-9.
This study was aimed to demonstrate growth in the pulmonary autograft after transplantation to the aortic position.
In 20 piglets (weight 25.4 +/- 3.5 kg) (mean +/- standard deviation) a Ross operation was performed and in five piglets (weight 9.3 +/- 0.7 kg) (mean +/- standard deviation) the ascending aorta was replaced with a valveless pulmonary autograft. Animals were allowed to grow as much as possible. Postmortem explanted autografts were studied by direct measurements of the valve cusps in the Ross group and of the wall segments in the valveless autograft group. Measurements of the first group were compared with the values of a separate control group, and values of the second group were compared with values of samples taken at operation.
In the Ross group, cuspal weight, height, and width increased significantly by comparison with body weight (p < or = 0.003). The rate of increase did not differ significantly from that of the control group with a native pulmonary valve. However, there was a rapid adaptation of the autograft valves resulting in a significantly higher mean cuspal weight, height, and width. In the valveless autograft group, wall circumference, thickness, and height increased significantly (p < or = 0.001). The circumference increased significantly more than that of the native pulmonary wall. Compared with the native aortic wall, the pulmonary autograft media showed retained pulmonary architecture on microscopic study.
These data suggest that the dimensional increase of the pulmonary autograft in the aortic position in the growing pig is determined by growth and dilatation, that the valve mass increases more than that of the native pulmonary valve, and that the characteristic pulmonary microscopic architecture is retained.
本研究旨在证明肺自体移植物移植至主动脉位置后的生长情况。
对20头仔猪（体重25.4±3.5千克）（均值±标准差）施行Ross手术，对5头仔猪（体重9.3±0.7千克）（均值±标准差）用无瓣肺自体移植物替换升主动脉。让动物尽可能生长。对死后取出的自体移植物进行研究，在Ross组直接测量瓣膜尖，在无瓣自体移植物组测量壁段。将第一组的测量值与一个单独对照组的值进行比较，将第二组的值与手术时采集的样本值进行比较。
在Ross组，与体重相比，瓣膜尖重量、高度和宽度显著增加（p≤0.003）。增加速率与有天然肺动脉瓣的对照组相比无显著差异。然而，自体移植瓣膜迅速适应，导致平均瓣膜尖重量、高度和宽度显著更高。在无瓣自体移植物组，壁周长、厚度和高度显著增加（p≤0.001）。周长增加显著多于天然肺动脉壁。与天然主动脉壁相比，肺自体移植物中层在显微镜研究中显示保留了肺结构。
这些数据表明，生长中的猪主动脉位置的肺自体移植物尺寸增加由生长和扩张决定，瓣膜质量增加多于天然肺动脉瓣，且保留了特征性的肺微观结构。
