A novel restorative pulmonary valved conduit in a chronic sheep model: Mid-term hemodynamic function and histologic assessment
A novel restorative pulmonary valved conduit in a chronic sheep model: Mid-term hemodynamic function and histologic assessment
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DOI：
10.1016/j.jtcvs.2017.12.046
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发表时间：
2018-06-01
影响因子：
6
通讯作者：
Virmani, Renu
中科院分区：
文献类型：
--
作者：
Bennink, Ger;Torii, Sho;Virmani, Renu
目标：为评价新型肺动脉带瓣管道（Xeltis Pulmonary Valved Conduit; XPV）在绵羊模型中长达12个月的安全性和短期功能，将XPV和汉考克生物瓣膜管道（H，用作对照）植入成年绵羊的肺动脉位置。在2个月（n = 6 XPV）、6个月（n = 6 XPV和n = 3 H）和12个月（n = 6 XPV）时处死动物并进行组织学检查。在后续行动中，该设备的功能，以及XPV和H的直径进行了评估transthoracic echocardiogram.Results：18只动物，接受了XPV，15存活，直到他们被杀死; 3只动物，接受H存活计划的观察间隔。XPV在2个月时开始出现轻度新生内膜增厚和降解，并持续至12个月。18只XPV动物中仅1只在6个月时出现显著钙化。病理学标本未显示任何明显的管道狭窄，而新生内膜厚度在6个月时达到峰值。炎症过程在6个月时达到最大，降解过程在12个月时达到最大。凝胶渗透色谱分析显示，导管在2个月时开始出现分子量损失，在12个月时达到峰值，瓣叶吸收较慢。H导管的壁显示更多的新生内膜增厚，狭窄，钙化相比，XPV，但小叶表现出最小的changes.Conclusions：两个导管表现出可接受的安全性和功能。在XPV中很少观察到显著的钙化，而在H中，随着壁的猪主动脉根部钙化，新生内膜厚度增加。
Objective: To evaluate the safety and the short-term function of a novel pulmonary valved conduit (Xeltis Pulmonary Valved Conduit; XPV) up to 12 months in a sheep model.Methods: XPV and Hancock bioprosthetic valved conduits (H, used as control) were implanted in adult sheep in the pulmonary artery position. Animals were killed at 2 months (n = 6 XPV), 6 months (n = 6 XPVand n = 3 H), and 12 months (n = 6 XPV) and examined histologically. During follow-up, function of the device as well as diameter of both XPVand H were assessed by transthoracic echocardiography.Results: Of 18 animals that received an XPV, 15 survived until they were killed; 3 animals that received H survived the planned observational interval. XPV showed mild neointimal thickening and degradation beginning at 2 months with an ongoing process until 12 months. Only 1 of the 18 animals with XPV had significant calcification at 6 months. Pathologic specimen did not show any significant narrowing of the conduit whereas neointimal thickness showed a peak at 6 months. Inflammatory process reached a maximum at 6 months and the degradation process at 12 months. Gel permeation chromatography analysis showed molecular weight loss beginning at 2 months with a peak at 12 months for the conduit with slower absorption for the leaflets. The wall of the H conduits showed more neointimal thickening, narrowing, and calcification compared with XPV, but the leaflets demonstrated minimal changes.Conclusions: Both conduits demonstrated an acceptable safety and functionality. Significant calcification was rarely observed in the XPV, whereas the H developed more neointimal thickness with calcification of the porcine aortic root portion of the wall.