Evidence-based surgical hypothesis: Partial heart transplantation can deliver growing valve implants for congenital cardiac surgery
Evidence-based surgical hypothesis: Partial heart transplantation can deliver growing valve implants for congenital cardiac surgery
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DOI：
10.1016/j.surg.2020.07.051
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发表时间：
2021-03-20
期刊：
影响因子：
3.8
通讯作者：
Rajab, Taufiek Konrad
中科院分区：
文献类型：
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作者：
Rajab, Taufiek Konrad
接受先天性心脏手术的儿童通常会长大，不能再植入瓣膜。因此，这些儿童致力于病态的再次手术，以接连更换他们已经长大的瓣膜植入物。因此，先天性心脏手术的圣杯是随着接受手术的孩子一起成长的瓣膜植入物。保存下来的同种移植物通常被用作瓣膜植入物，但它们不会随着孩子的成长而生长，因为它们在保存期间失去了生存能力。相比之下，自体肺移植和儿科心脏移植随着受者儿童的成长而成长。同样，部分心脏移植可以为先天性心脏手术提供越来越多的瓣膜植入物。只有在成年儿童的部分心脏移植可以换成成人大小的人工瓣膜之前，才需要暂时的免疫抑制。？2020爱思唯尔公司。保留所有权利。接受先天性心脏手术的儿童通常会超过瓣膜植入物的年龄。因此，这些儿童致力于病态的再次手术，以接连更换他们已经长大的瓣膜植入物。因此，先天性心脏手术的圣杯是随着接受手术的孩子一起成长的瓣膜植入物。保存下来的同种移植物通常被用作瓣膜植入物，但它们不会随着孩子的成长而生长，因为它们在保存期间失去了生存能力。相比之下，自体肺移植和儿科心脏移植随着受者儿童的成长而成长。同样，部分心脏移植可以为先天性心脏手术提供越来越多的瓣膜植入物。只有在成年儿童的部分心脏移植可以换成成人大小的人工瓣膜之前，才需要暂时的免疫抑制。
Children undergoing congenital cardiac surgery often outgrow the valve implants. These children are thus committed to morbid reoperations for successive exchanges of the vavular implants that they have outgrown. Therefore the holy grail of congenital cardiac surgery is a valve implant that grows with the recipient child. Preserved homografts routinely are used as valve implants, but they do not grow as the child grows because they lose viability during preservation. In contrast, pulmonary autografts and pediatric heart transplants grow with the recipient children. Similarly, partial heart transplantation can deliver growing valve implants for congenital cardiac surgery. Temporary immune suppression would only be needed until the partial heart transplant can be exchanged for an adult-sized prosthetic valve in the grown child. ? 2020 Elsevier Inc. All rights reserved.Children undergoing congenital cardiac surgery often outgrow the valve implants. These children are thus committed to morbid reoperations for successive exchanges of the vavular implants that they have outgrown. Therefore the holy grail of congenital cardiac surgery is a valve implant that grows with the recipient child. Preserved homografts routinely are used as valve implants, but they do not grow as the child grows because they lose viability during preservation. In contrast, pulmonary autografts and pediatric heart transplants grow with the recipient children. Similarly, partial heart transplantation can deliver growing valve implants for congenital cardiac surgery. Temporary immune suppression would only be needed until the partial heart transplant can be exchanged for an adult-sized prosthetic valve in the grown child.