Ross operation with a tissue-engineered heart valve.
نویسندگان
چکیده
BACKGROUND The Ross procedure has gained increasing acceptance due to excellent hemodynamic results by replacing the diseased aortic valve with the viable autologous pulmonary valve. Consequently, the right ventricular outflow tract (RVOT) has to be reconstructed. In this report a viable heart valve was created from decellularized cryopreserved pulmonary allograft that was seeded with viable autologous vascular endothelial cells (AVEC). METHODS A 43-year-old patient suffering from aortic valve stenosis underwent a Ross operation on May 20, 2000, using a tissue engineered (TE) pulmonary allograft to reconstruct the RVOT. Four weeks before the operation a piece of forearm vein was harvested to separate, culture, and characterize AVEC. Follow-up was completed at discharge, 3, 6, and 12 months postoperatively by clinical evaluation, transthoracic echocardiography (TTE), and magnetic resonance imaging (MRI). Additionally, at 1-year follow-up a multislice computed tomographic scan was performed. RESULTS After four weeks of culturing 8.34 x 10(6) AVEC were available to seed a 27-mm decellularized pulmonary allograft. Trypan blue staining confirmed 96.0% viability. Reendothelialization rate after seeding was 9.0 x 10(5) cells/cm2. TTE and MRI revealed excellent hemodynamic function of the TE heart valve and the neoaortic valve as well. Multislice computed tomography revealed no evidence of valvular calcification. CONCLUSIONS After 1 year of follow-up the patient is in excellent condition without limitation and exhibits normal aortic and pulmonary valve function.
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I read with great interest the article by Hraska et al. [1], in the May issue of EJCTS, summarizing their 7 years experience with the Ross and Ross–Konno operation in children and adolescents in two centers. Like most other series, their mid-term experience validates the safety and efficacy of Ross operation in treating aortic valve disease in this important subset of patients where growth, act...
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عنوان ژورنال:
- The Annals of thoracic surgery
دوره 74 5 شماره
صفحات -
تاریخ انتشار 2002