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Mid-Term Clinical Results Using a Tissue-Engineered Pulmonary Valve to Reconstruct the Right Ventricular Outflow Tract During the Ross Procedure  Pascal.

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Presentation on theme: "Mid-Term Clinical Results Using a Tissue-Engineered Pulmonary Valve to Reconstruct the Right Ventricular Outflow Tract During the Ross Procedure  Pascal."— Presentation transcript:

1 Mid-Term Clinical Results Using a Tissue-Engineered Pulmonary Valve to Reconstruct the Right Ventricular Outflow Tract During the Ross Procedure  Pascal M. Dohmen, MD, PhD, Alexander Lembcke, MD, Sebastin Holinski, MD, Dietmar Kivelitz, PhD, Jan P. Braun, MD, Axel Pruss, PhD, Wolfgang Konertz, MD, PhD  The Annals of Thoracic Surgery  Volume 84, Issue 3, Pages (September 2007) DOI: /j.athoracsur Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 A representative Giemsa-stained sample of a seeded valve wall shows effective in vitro endothelial cell seeding. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Magnetic resonance imaging shows a distal anastomosis narrowing. There is absence of prestenotic dilatation of the valve wall. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Hematoxylin and eosin staining shows excellent preservation of the extracellular structures, surrounded by tissue fibrosis. (B) Goldner staining shows an unchanged extracellular matrix. (C) Von Kossa staining shows absence of tissue calcification. (D) The valve wall shows a monolayer of CD31-positive cells at the inner surface of the valve wall. (E) The cells at the inner surface are also CD34-positive cells. Some CD34-positive cells are identified within the superficial area of the wall media. (F) In the deeper layers of the wall media, many CD34 positive cells are identified, which shows new revascularization. (G) There are a few CD68-positive cells within the matrix, as shown in this photomicrograph. (H) The cells shown within the extracellular matrix are antifibroblast positive cells. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 (A) Average mean flow velocities at the tissue-engineered (TE) heart valve (triangles, dark line) and the neoaortic valve (diamonds, light line). (B) Average mean flow velocities of the allogenic (light line, squares) and xenogenic (dark line, triangle) matrices are used for construction of the TE heart valve. Data are presented with the standard deviation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Multislice computed tomography image shows normal morphology, without calcification, at the 5-year follow-up. (A) The leaflets of the tissue-engineered heart valve are completely opened. (B) The smooth and pliable leaflets are closed. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

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