Semilunar valve growth and function 10 years after infant heart transplantation: Predicting long-term outcomes of partial heart transplants.
Semilunar valve growth and function 10 years after infant heart transplantation: Predicting long-term outcomes of partial heart transplants.
复制标题
婴儿心脏移植后 10 年半月瓣的生长和功能：预测部分心脏移植的长期结果。
DOI：
10.1111/petr.14746
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发表时间：
2024
影响因子：
1.3
通讯作者：
McVadon,DeaniH
中科院分区：
文献类型：
--
作者：
Rajab,TaufiekK;Abdelrahman,Mohamed;Schwartzenburg,ElridgeJ;Aykut,Berk;Turek,JosephW;McVadon,DeaniH
简介部分心脏移植是一种新型儿科移植，用包含必要瓣膜的匹配供体心脏部分替换有缺陷的心脏瓣膜。部分心脏移植的短期结果良好，但长期结果尚不清楚。为了预测部分心脏移植的长期结果，我们评估了作为心脏移植一部分的婴儿期移植的半月形心脏瓣膜的长期生长和功能。方法本研究纳入了 1997 年至 2014 年在单一中心接受婴儿心脏移植的所有儿童。心脏移植后和 10 年后无法进行超声心动图检查的儿童被排除在外。两位作者回顾了超声心动图，以分析半月瓣环直径、Z 分数、峰值瓣膜梯度和瓣膜反流。使用双尾、配对样本检验和 Bonferroni 校正进行多重比较来确定统计差异。结果分析了 15 名患者的数据。移植后主动脉瓣环平均为 1.3cm（范围 0.7-1.8cm），10 年后增长至平均 1.7cm（范围 1.4-2.3cm）（p<0.001）。 10年后，主动脉瓣峰值梯度平均为5.1mmHg（范围2.1-15.5mmHg），并且没有一个瓣膜出现轻微的反流。移植后肺动脉瓣环平均为 1.5cm（范围 1.1-2.5cm），10 年后增长至平均 2.1cm（范围 1.0-2.9cm）（p<0.001）。 10年后，肺动脉瓣峰值梯度平均为4.3mmHg（范围1.1-13.8mmHg），7%的瓣膜有中度反流。讨论作为心脏移植的一部分，在婴儿期移植的半月形心脏瓣膜在10年后表现出统计上显着的生长和良好的功能。这预示着部分心脏移植的长期效果良好。
IntroductionPartial heart transplants are a new type of pediatric transplant that replace defective heart valves with the parts of matched donor hearts containing the necessary valves. Short‐term outcomes of partial heart transplants are excellent, but long‐term outcomes are unknown. In order to predict the long‐term outcomes of partial heart transplants, we evaluated long‐term growth and function of semilunar heart valves transplanted in infancy as part of a heart transplant.MethodsAll children who underwent infant heart transplantation at a single center from 1997 to 2014 were included in this study. Children in whom echocardiograms after heart transplantation and after 10 years were not available for review were excluded. The echocardiograms were reviewed by two authors to analyze semilunar valve annulus diameters,Z‐scores, peak valve gradients, and valve regurgitation. Statistical difference was determined using two‐tailed, paired samplet‐tests with Bonferroni correction for multiple comparisons.ResultsData from 15 patients were analyzed. The aortic valve annulus averaged 1.3 cm (range 0.7–1.8 cm) immediately after transplantation and grew to an average of 1.7 cm (range 1.4–2.3 cm) after 10 years (p< .001). After 10 years, the aortic valve peak gradient avereraged 5.1 mmHg (range 2.1–15.5 mmHg) and none of the valves had more than trivial regurgitation. The pulmonary valve annulus averaged 1.5 cm (range 1.1–2.5 cm) immediately after transplantation and grew to an average of 2.1 cm (range 1.0–2.9 cm) after 10 years (p< .001). After 10 years, the pulmonary valve peak gradient averaged 4.3 mmHg (range 1.1–13.8 mmHg), and 7% of valves had moderate regurgitation.DiscussionSemilunar heart valves transplanted in infancy as part of a heart transplant demonstrate statistically significant growth and excellent function after 10 years. This predicts excellent long‐term outcomes of partial heart transplants.