Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective

Objectives: The objectives of this study were to evaluate the results when tissue-engineered vascular grafts (TEVGs) are used as alternatives to autologous pericardium for surgically augmenting the pulmonary artery (PA) or aortic valve. Methods: TEVG molds were embedded into subcutaneous spaces for...

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Main Authors: Hisayuki Hongu, MD, PhD, Masaaki Yamagishi, MD, PhD, Keiichi Kanda, MD, PhD, Yoshinobu Maeda, MD, Tomoya Inoue, MD, PhD, Hiroki Nakatsuji, MD, PhD, Hitoshi Yaku, MD, PhD
Format: Article
Language:English
Published: Elsevier 2022-04-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250722000165
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author Hisayuki Hongu, MD, PhD
Masaaki Yamagishi, MD, PhD
Keiichi Kanda, MD, PhD
Yoshinobu Maeda, MD
Tomoya Inoue, MD, PhD
Hiroki Nakatsuji, MD, PhD
Hitoshi Yaku, MD, PhD
author_facet Hisayuki Hongu, MD, PhD
Masaaki Yamagishi, MD, PhD
Keiichi Kanda, MD, PhD
Yoshinobu Maeda, MD
Tomoya Inoue, MD, PhD
Hiroki Nakatsuji, MD, PhD
Hitoshi Yaku, MD, PhD
author_sort Hisayuki Hongu, MD, PhD
collection DOAJ
description Objectives: The objectives of this study were to evaluate the results when tissue-engineered vascular grafts (TEVGs) are used as alternatives to autologous pericardium for surgically augmenting the pulmonary artery (PA) or aortic valve. Methods: TEVG molds were embedded into subcutaneous spaces for more than 4 weeks preoperatively. Since 2014, 6 patients have undergone PA reconstruction, whereas 1 has undergone aortic valve plasty (AVP) with TEVGs. The time from mold implantation to the operation was 8.9 (range, 6.0-26.4) months. The age and body weight at the time of operation were 2.7 (range, 1.8-9.2) and 11.6 (range, 7.9-24.4) kg, respectively. Concomitant procedures comprised the Rastelli, palliative Rastelli, and Fontan operations in 2, 2, and 1 patient, respectively. Results: The median follow-up period was 14.4 (range, 3-39.6) months. There were no early or late mortalities. Moreover, there were no TEVG-related complications, including aneurysmal changes, degeneration, and infection. In 5 patients who underwent PA augmentation, the postoperative PA configuration was satisfactorily dilated. The reconstructed aortic valve function was good in the patient who underwent AVP. Decreased leaflet flexibility due to leaflet thickening was not observed. One patient had postoperative PA re-stenosis; therefore, re-PA augmentation with TEVGs was performed. On histological examination, TEVGs consisted of collagen fibers and few fibroblasts, and elastic fiber formation and/or smooth muscle cells were not observed. Conclusions: The midterm results of PA reconstruction and AVP with TEVGs were satisfactory. TEVGs might be a useful alternative to autologous pericardium in pediatric cardiovascular surgeries that often require multistage operations.
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spelling doaj-art-8d7b8700a86f4ac8976e85a0099f97862025-08-20T03:36:37ZengElsevierJTCVS Techniques2666-25072022-04-011214315210.1016/j.xjtc.2021.09.058Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspectiveHisayuki Hongu, MD, PhD0Masaaki Yamagishi, MD, PhD1Keiichi Kanda, MD, PhD2Yoshinobu Maeda, MD3Tomoya Inoue, MD, PhD4Hiroki Nakatsuji, MD, PhD5Hitoshi Yaku, MD, PhD6Department of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan; Address for reprints:Masaaki Yamagishi, MD, PhD, Department of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.Division of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, Kyoto, JapanDivision of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Pediatric Cardiovascular Surgery, Children's Medical Center, Kyoto Prefectural University of Medicine, Kyoto, JapanDivision of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, JapanObjectives: The objectives of this study were to evaluate the results when tissue-engineered vascular grafts (TEVGs) are used as alternatives to autologous pericardium for surgically augmenting the pulmonary artery (PA) or aortic valve. Methods: TEVG molds were embedded into subcutaneous spaces for more than 4 weeks preoperatively. Since 2014, 6 patients have undergone PA reconstruction, whereas 1 has undergone aortic valve plasty (AVP) with TEVGs. The time from mold implantation to the operation was 8.9 (range, 6.0-26.4) months. The age and body weight at the time of operation were 2.7 (range, 1.8-9.2) and 11.6 (range, 7.9-24.4) kg, respectively. Concomitant procedures comprised the Rastelli, palliative Rastelli, and Fontan operations in 2, 2, and 1 patient, respectively. Results: The median follow-up period was 14.4 (range, 3-39.6) months. There were no early or late mortalities. Moreover, there were no TEVG-related complications, including aneurysmal changes, degeneration, and infection. In 5 patients who underwent PA augmentation, the postoperative PA configuration was satisfactorily dilated. The reconstructed aortic valve function was good in the patient who underwent AVP. Decreased leaflet flexibility due to leaflet thickening was not observed. One patient had postoperative PA re-stenosis; therefore, re-PA augmentation with TEVGs was performed. On histological examination, TEVGs consisted of collagen fibers and few fibroblasts, and elastic fiber formation and/or smooth muscle cells were not observed. Conclusions: The midterm results of PA reconstruction and AVP with TEVGs were satisfactory. TEVGs might be a useful alternative to autologous pericardium in pediatric cardiovascular surgeries that often require multistage operations.http://www.sciencedirect.com/science/article/pii/S2666250722000165tissue-engineered vascular graftsautologous pericardiumpulmonary arteryaortic valve plastypediatric cardiovascular surgery
spellingShingle Hisayuki Hongu, MD, PhD
Masaaki Yamagishi, MD, PhD
Keiichi Kanda, MD, PhD
Yoshinobu Maeda, MD
Tomoya Inoue, MD, PhD
Hiroki Nakatsuji, MD, PhD
Hitoshi Yaku, MD, PhD
Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
JTCVS Techniques
tissue-engineered vascular grafts
autologous pericardium
pulmonary artery
aortic valve plasty
pediatric cardiovascular surgery
title Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
title_full Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
title_fullStr Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
title_full_unstemmed Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
title_short Pulmonary artery augmentation and aortic valve repair using novel tissue-engineered graftsCentral MessagePerspective
title_sort pulmonary artery augmentation and aortic valve repair using novel tissue engineered graftscentral messageperspective
topic tissue-engineered vascular grafts
autologous pericardium
pulmonary artery
aortic valve plasty
pediatric cardiovascular surgery
url http://www.sciencedirect.com/science/article/pii/S2666250722000165
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