Partial heart transplantation: Growing heart valve implants for children

Rajab, Taufiek Konrad

doi:10.1111/aor.14664

Cited by 6 publications

(2 citation statements)

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“…This allows P-HTs to grow with the recipient. Short-term outcomes of P-HT were evaluated in piglets for months 2,3 and in the first human patients for 1 year. 4 However, the long-term outcomes of P-HT are unknown.…”

Section: Introductionmentioning

confidence: 99%

Semilunar valve growth and function 10 years after infant heart transplantation: Predicting long‐term outcomes of partial heart transplants

Rajab,

Abdelrahman,

Schwartzenburg

et al. 2024

Pediatric Transplantation

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IntroductionPartial heart transplants are a new type of pediatric transplant that replace defective heart valves with the parts of matched donor hearts containing the necessary valves. Short‐term outcomes of partial heart transplants are excellent, but long‐term outcomes are unknown. In order to predict the long‐term outcomes of partial heart transplants, we evaluated long‐term growth and function of semilunar heart valves transplanted in infancy as part of a heart transplant.MethodsAll children who underwent infant heart transplantation at a single center from 1997 to 2014 were included in this study. Children in whom echocardiograms after heart transplantation and after 10 years were not available for review were excluded. The echocardiograms were reviewed by two authors to analyze semilunar valve annulus diameters, Z‐scores, peak valve gradients, and valve regurgitation. Statistical difference was determined using two‐tailed, paired sample t‐tests with Bonferroni correction for multiple comparisons.ResultsData from 15 patients were analyzed. The aortic valve annulus averaged 1.3 cm (range 0.7–1.8 cm) immediately after transplantation and grew to an average of 1.7 cm (range 1.4–2.3 cm) after 10 years (p < .001). After 10 years, the aortic valve peak gradient avereraged 5.1 mmHg (range 2.1–15.5 mmHg) and none of the valves had more than trivial regurgitation. The pulmonary valve annulus averaged 1.5 cm (range 1.1–2.5 cm) immediately after transplantation and grew to an average of 2.1 cm (range 1.0–2.9 cm) after 10 years (p < .001). After 10 years, the pulmonary valve peak gradient averaged 4.3 mmHg (range 1.1–13.8 mmHg), and 7% of valves had moderate regurgitation.DiscussionSemilunar heart valves transplanted in infancy as part of a heart transplant demonstrate statistically significant growth and excellent function after 10 years. This predicts excellent long‐term outcomes of partial heart transplants.

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Section: Introductionmentioning

confidence: 99%

Semilunar valve growth and function 10 years after infant heart transplantation: Predicting long‐term outcomes of partial heart transplants

Rajab,

Abdelrahman,

Schwartzenburg

et al. 2024

Pediatric Transplantation

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“…Stented bovine jugular vein grafts, which can be balloon-dilated over time, have been shown promise 2 ; however, there is an urgent need for a heart implant that is durable and potentially limits reoperations in this challenging cohort. Partial heart transplantation uses living homografts 3 and has been hypothesized to treat congenital diseases involving semilunar valve dysfunction such as truncus arteriosus 4 and been simulated on 3-dimensional (3D)-printed models to assess feasibility and to refine surgical techniques. 5 We hypothesized that this methodology could be used to explore the feasibility of partial heart transplantation of the AVV in complete atrial septal defect (AVSD) using silicone-molded heart models.…”

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confidence: 99%