PDF(Pubmed)
Abstract：
Objectives: A self-constructed valved pulmonary conduit made out of a de-cellularized porcine small intestinal submucosal extracellular matrix biological scaffold was tested in a chronic growing lamb model. Methods: The conduit was implanted in pulmonary valve position in 19 lambs. We monitored clinical, laboratory, and echocardiographic findings until 12 months after surgery. In two animals, euthanasia was planned at nine and twelve months. Pre-mortem chest computed tomography and post-mortem pathologic work up were performed. Data are presented as frequency and percentage, median and range, or mean and standard deviation. Results: Twelve (63.2%) animals survived the perioperative period. Three unexpected deaths occurred during the follow-up period: one due to aspiration pneumonia at 23 days after surgery, and two due to early and late infective endocarditis of the conduit at 18 and 256 days. In the two animals with planned scarification, the pre-mortem CT scan revealed mild or no calcification within the conduit or valve leaflets. In the echocardiographic examination at 12 months, peak and mean systolic pressure gradients across the conduit valve were 6.5 (3-21) mmHg and 3 (2-12) mmHg, while valve regurgitation was none (n = 2), trivial (n = 5), moderate (n = 1), or severe (n = 1). No clinical or laboratory signs of hemolysis were seen. After 12 months of follow-up, the animals\' body weights had increased from 33 (27-38) kg to 53 (38-66) kg (p = 0.010). Conclusions: Implantation of a valved pulmonary conduit in our growing lamb model was feasible. Infective endocarditis of the implanted valved conduit remained a significant complication.
摘要：
目的：在慢性生长的羔羊模型中测试了由去细胞化猪小肠粘膜下细胞外基质生物支架制成的自构建的带瓣膜的肺导管。方法：将导管植入19只羔羊的肺动脉瓣位置。我们监测了临床，实验室,直到手术后12个月的超声心动图检查结果。在两只动物中，安乐死计划在9个月和12个月。进行了死前胸部计算机断层扫描和死后病理检查。数据以频率和百分比表示，中位数和范围，或平均值和标准偏差。结果:围手术期12只(63.2%)动物存活。随访期间发生3例意外死亡:1例术后23天因吸入性肺炎,和两个由于导管的早期和晚期感染性心内膜炎在18天和256天。在计划割伤的两只动物中，验尸前CT扫描显示导管或瓣膜小叶内轻度或无钙化.在12个月的超声心动图检查中，导管瓣膜的峰值和平均收缩压梯度分别为6.5（3-21）mmHg和3（2-12）mmHg，而无瓣膜返流（n=2），琐碎(n=5)，中等(n=1)，或严重（n=1）。未见溶血的临床或实验室征象。经过12个月的随访，动物体重从33（27-38）kg增加到53（38-66）kg（p=0.010）。结论：在我们生长的羔羊模型中植入带瓣膜的肺导管是可行的。植入瓣膜导管的感染性心内膜炎仍然是重要的并发症。
