Ten Years of Clinical Results With a Tissue-Engineered Pulmonary Valve
Ten Years of Clinical Results With a Tissue-Engineered Pulmonary Valve
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DOI：
10.1016/j.athoracsur.2011.06.009
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发表时间：
2011-10-01
影响因子：
4.6
通讯作者：
Konertz, Wolfgang
中科院分区：
文献类型：
--
作者：
Dohmen, Pascal M.;Lembcke, Alexander;Konertz, Wolfgang
背景资料。本研究旨在收集ROSS手术期间植入用于重建右室流出道的组织工程心脏瓣膜的前瞻性安全性和有效性数据。从2000年5月到2002年6月，连续11名患者接受了组织工程心脏瓣膜(欧洲心脏手术风险评估系统添加剂和Logistic分别为3.3+/-1.3和2.8%+/-1.4%)，平均年龄为39.6±/-10.3岁。在Ross手术前2-4周，取一段前臂静脉或隐静脉分离、鉴定和扩增内皮细胞。使用一种特殊开发的生物反应器，将冷冻保存的同种异体肺移植物脱细胞、包被并种植自体血管内皮细胞。细胞接种密度为1.1×10(5)+/-0.5×10(5)个/cm(2)，细胞存活率为93.2%+/-2.1%。所有患者均在手术中存活。术后未发现不明原因发热。目前所有患者均为纽约心脏协会I级患者。经胸超声心动图对组织工程心脏瓣膜的评估显示，10年后平均压力梯度为5.4+/-2.0 mm Hg。多层螺旋CT显示10年内无钙化。组织工程化心脏瓣膜显示出良好的血流动力学性能，并可能在长期随访中防止退化。(Ann Thorac Surg 2011；92：1308-14)(C)2011年，胸外科学会
Background. This study was performed to collect prospective safety and effectiveness data from a tissue-engineered heart valve implanted for reconstruction of the right ventricular outflow tract during the Ross operation.Methods. From May 2000 until June 2002, 11 consecutive patients, mean age 39.6 +/- 10.3 years, received a tissue-engineered heart valve (additive and logistic European System for Cardiac Operative Risk Evaluation, respectively, 3.3 +/- 1.3 and 2.8% +/- 1.4%). Two to four weeks prior to the Ross operation a piece of forearm vein or saphenous vein was harvested to isolate, characterize, and expand endothelial cells. A cryopreserved pulmonary allograft was decellularized, coated, and seeded with autologous vascular endothelial cells, using a specially developed bioreactor. Cell seeding density was 1.1 x 10(5) +/- 0.5 x 10(5) cells/cm(2) with a viability of 93.2% +/- 2.1%.Results. All patients survived surgery. Postoperatively no fever of unknown origin was evident. Currently all patients are in New York Heart Association class I. Evaluation of the tissue-engineered heart valve by transthoracic echocardiography showed a mean pressure gradient of 5.4 +/- 2.0 mm Hg at 10 years. Multislice computed tomography showed no calcification up to 10 years.Conclusions. Tissue-engineered heart valves showed excellent hemodynamic performance and may prevent degeneration during long-term follow-up. (Ann Thorac Surg 2011;92:1308-14) (C) 2011 by The Society of Thoracic Surgeons