Initial Clinical Trial of a Novel Pulmonary Valved Conduit.
TL;DR: In this paper, the first clinical use of a completely bioabsorbable valved conduit (Xeltis pulmonary valve - XPV) in children was reported, which is a promising innovation for RVOT reconstruction.
About: This article is published in Seminars in Thoracic and Cardiovascular Surgery.The article was published on 2021-05-11. It has received 7 citations till now. The article focuses on the topics: Medicine & Ventricular outflow tract.
Citations
More filters
TL;DR: In this paper , a review of tissue-engineered heart valves and partial heart transplantation as potential growing heart valve implants in large animal and clinical translational research is presented, as well as the barriers to clinical translation.
Abstract: The current standard of care for pediatric patients with unrepairable congenital valvular disease is a heart valve implant. However, current heart valve implants are unable to accommodate the somatic growth of the recipient, preventing long-term clinical success in these patients. Therefore, there is an urgent need for a growing heart valve implant for children. This article reviews recent studies investigating tissue-engineered heart valves and partial heart transplantation as potential growing heart valve implants in large animal and clinical translational research. In vitro and in situ designs of tissue engineered heart valves are discussed, as well as the barriers to clinical translation.
4 citations
TL;DR: Among the 40,000 children born every year in the USA with a congenital heart disease, more than 16,400 will need the implantation of a valve or a valved conduit to replace the pulmonary valve (PV) or the right ventricular outflow tract (RVOT) at least once during their lifetime as mentioned in this paper .
4 citations
TL;DR: In this paper , the authors report the first clinical use of a completely bioabsorbable valved conduit (Xeltis pulmonary valve - XPV) in children, in which 12 children (six male, median age five (two to twelve) years and median weight 17 (10 to 43) kg, underwent RVOT reconstruction with the XPV.
TL;DR: In this article , the authors focus on the different past and present surgical options and present a new concept called "endogenous tissue restoration", a promising alternative to the hitherto existing implants. But they do not consider the use of autologous tissue.
Abstract: The pulmonary valve is the most frequently replaced cardiac valve in congenital heart diseases. Whether the valve alone or part of the right ventricular outflow tract have to be repaired or replaced depends on the specific pathological anatomy of the malformation. Once the decision to replace the pulmonary valve has been made, two options are available: the isolated transcatheter pulmonary valve replacement and the surgical implantation of a prosthetic valve either isolated or in combination with a procedure on the right ventricular outflow tract. In this paper, we will focus on the different past and present surgical options and present a new concept called “endogenous tissue restoration,” a promising alternative to the hitherto existing implants. From a general point of view, neither the transcatheter nor the surgical valvular implants are magic bullets in the arsenal for the management of valvular diseases. Smaller valves have to be frequently replaced because of outgrowth of the patients, larger tissue valves may present late structural valve deterioration, while xenograft and homograft conduits may calcify and therefore become narrowed within unpredictable incidence and interval following implantation. Based on long-term research efforts combining the knowledge of supramolecular chemistry, electrospinning, and regenerative medicine, endogenous tissue restoration has emerged most recently as a promising option to create long-term functioning implants. This technology is appealing because following resorption of the polymer scaffold and timely replacement through autologous tissue, no foreign material remain at all in the cardiovascular system. Proof-of-concept studies as well as small first-in-man series have been completed and have demonstrated favorable anatomic and hemodynamic results, comparable to currently available implants in the short term. Based on the initial experience, important modifications to improve the pulmonary valve function have been initiated.
References
More filters
TL;DR: A report from the American Society of Echocardiography’s Nomenclature and Standards Committee and The Task Force on Valvular Regurgitation developed in conjunction with the American College of Cardiology EchOCardiography Committee.
3,769 citations
01 Jan 2014
2,059 citations
TL;DR: The most common cause for failure is conduit obstruction with thickening and shrinkage at the annular area and placement of a smaller homograft at the initial operation may decrease the incidence of conduit kinking, sternal compression, and posterior shelf impingement.
151 citations
TL;DR: Both conduits demonstrated an acceptable safety and functionality and significant calcification was rarely observed in the XPV, whereas the H developed more neointimal thickness with calcification of the porcine aortic root portion of the wall.
78 citations
TL;DR: CryoValve SGs demonstrate superior freedom from significant insufficiency at intermediate follow-up when compared with standard allografts, and in older children, CryoValving SGs display less insuffiencies and stenosis.
74 citations