三叶半月瓣重建术:急性猪体内评估

IF 1.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Lisa Carlson Hanse, Marcell Juan Tjørnild, Zarmiga Karunanithi, Johannes Høgfeldt Jedrzejczyk, Lejla Islamagič, Nynne Emilie Hummelshøj, Malene Enevoldsen, Germán Lugones, Mette Høj Lauridsen, Vibeke Elisabeth Hjortdal, Ignacio Lugones
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引用次数: 0

摘要

目的:手术治疗先天性心脏缺陷中的畸形半月瓣是一项具有挑战性的工作,既要保证受术者的寿命,又要保证受术者的成长潜力。我们在急性猪模型中研究了一种新的外科技术 "三叶半月瓣重建术",这种技术的几何特性既能保证足够的寿命,又能使瓣膜随着受术者的成长而成长。方法:使用 60 公斤重的急性猪模型。通过超声心动图检查了肺动脉瓣的几何形状和血流动力学基线。在心肺旁路手术中,剥离肺动脉瓣叶,用定制的同种异体心包新瓣叶进行三叶半月瓣重建。脱离旁路后,重新评估血液动力学。结果对 12 只动物进行了调查。其中十只动物的新瓣膜功能正常,两只动物的新瓣膜反流极少。新瓣膜的峰值梯度为 3 ± 2 mm Hg,峰值速度为 0.8 ± 0.2 m/s。新瓣膜的合流平均增加了 4 ± 3 毫米,P 结论:在这个急性猪模型中,新瓣膜没有临床意义上的反流或狭窄。新瓣膜的吻合度增加,呈风车状,瓣叶在瓣环平面呈波浪状。随着患儿的成长,瓣环和肺动脉的尺寸也会增大,这些几何特征可能会使瓣膜持续充足。应进行进一步的长期研究,以评估其疗效和生长潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation.

Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique "Trileaflet Semilunar Valve Reconstruction" in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P < .001. The neo-valve had a windmill shape in the echocardiographic short-axis view, and the neo-leaflets billowed at the annular plane in the long-axis view. Conclusions: In this acute porcine model, the neo-valve had no clinically significant regurgitation or stenosis. The neo-valve had an increased coaptation, a windmill shape, and leaflets that billowed at the annular plane. These geometric findings may allow for sustained sufficiency as the annular and pulmonary artery dimension increase with the child's growth. Further long-term studies should be performed to evaluate the efficacy and the growth potential.

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来源期刊
CiteScore
1.80
自引率
11.10%
发文量
128
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