DONOR HEART VALVES RECONSTRUCTION BEFORE TRANSPLANTATION
https://doi.org/10.15825/1995-1191-2013-2-36-43
Abstract
Aim of study. The demonstration of our own experience in heart transplantation after valve reconstruction. Methods and results. From May 2012 to March 2013 3 mitral valve annuloplasties were performed to recipi- ents, requiring urgent HT and having extremely unfavorable prognosis of survival without HT. The recipients were classified as United Network for Organ Sharing (UNOS) IB, and all of them were on inotropic support. In one case, HT was performed after reconstruction of rheumatic mitral stenosis, in two other cases – after dege- nerative mitral regurgitation. The technical aspects are reviewed of ex-vivo mitral and tricuspid valves repair with concomitant heart transplantation. All patients were discharged from the hospital having excellent postope- rative recovery. Conclusion. Taking into consideration the demonstrated satisfactory result of surveillance and presence of significant experience in performing of reconstructive valve surgery among no-HT cardiosurgical patients, an increase in the pool of suitable donor organs is expected due to the liberalization of the selection criteria and the possibility of the innovative valve reconstruction procedures ex vivo.
About the Authors
S. V. Gautier
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
R. S. Saitgareev
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
V. N. Poptsov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
D. V. Shumakov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
G. A. Akopov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
V. M. Zakharevich
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
I.M. Sechenov First Moscow State Medical University (Rector – corresponding member of RAMSci,
prof. P.V. Glybochko). Department of Transplantology and Artificial organs (Head – academician
of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
A. Y. Kormer
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
E. A. Spirina
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
References
1. Taylor D.O., Edwards L.B., Aurora P., Christie J.D., Dobbels F., Kirk R., Rahmel A.O., Kucheryavaya A.Y., Hertz M.I. Registry of the international society for heart and lung transplantation: twenty-fifth official adult heart transplant report – 2008 // J. Heart Lung Transplant.
2. ; 27: 943–956.
3. Готье С.В., Мойсюк Я.Г., Хомяков С.М., Ибраги-
4. мова О.С. Органное донорство и трансплантация в Российской Федерации в 2011 году // Вестник транс- плантологии и искусственных органов. 2012; 14 (3): 6–19.
5. Got'e S.V., Mojsjuk Ja.G., Homjakov S.M., Ibragimo- va O.S. Organnoe donorstvo i transplantacija v Rossijs- koj Federacii v 2011 godu // Vestnik transplantologii i iskusstvennyh organov. 2012; 14 (3): 6–19.
6. Pawale A., Tang G.H.L., Milla F. Bench mitral valve re- pair of donor hearts before orthotopic heart transplantati- on // Circulation: Heart Failure. 2012; 5: 96–97.
7. Zaroff J.G., Rosengard B.R., Armstrong W.F., Bab- cock W.D., D'Alessandro A., Dec G.W, Edwards N.M., Higgins R.S, Jeevanandum V., Kauffman M., Kirk- lin J.K., Large S.R., Marelli D., Peterson T.S., Ring W.S., Robbins R.C., Russell S.D., Taylor D.O., Van Bakel A., Wallwork J., Young J.B. Maximizing use of organs re- covered from the cadaver donor cardiac recommenda- tions // Circulation. 2002; 106: 836–841.
8. Sweeney M.S., Lammermeier D.E., Frazier O.H., Bur- nett C.M., Haupt H.M., Duncan J.M. Extension of the donor criteria in cardiac transplantation: surgical risks versus supply-side economics // Ann. Thorac. Surg. 1990; 50: 7–11.
9. Russo M. J., Davies R. R., Hong K. N., Chen J.M., Ar- genziano M., Moskowitz A., Ascheim D.D., George I., Stewart A.S., Williams M., Gelijns A., Naka Y. Matching high-risk recipients with marginal donor hearts is a cli- nically effective strategy // Ann. Thorac. Surg. April 1, 2009; 87 (4): 1066–1071.
10. Попцов В.Н., Спирина Е.А., Пчельников В.В., Иль- ин Д.С., Ильинский В.С. Оптимизация органного до- норства при реализации программы трансплантации сердца // Эфферентная терапия. 2011; 17 (3): 121–122. Popcov V.N., Spirina E.A., Pchel'nikov V.V., Il'in D.S., Il'inskij V.S. Optimizacija organnogo donorstva pri rea- lizacii programmy transplantacii serdca // Jefferentnaja terapija. 2011; 17 (3): 121–122.
11. Попцов В.Н., Спирина Е.А., Ильин Д.С., Пчельни- ков В.В., Ильинский В.А., Кугунева Н.А. Периопе- рационнный период при трансплантации сердца от доноров старше 40 лет // Вестник трансплантологии и искусственных органов. Том XIV. Приложение. Материалы VI Всероссийского съезда транспланто- логов. М., 2012: 246.
12. Popcov V.N., Spirina E.A., Il'in D.S., Pchel'nikov V.V., Il'inskij V.A., Kuguneva N.A. Perioperacionnnyj period pri transplantacii serdca ot donorov starshe 40 let // Vest- nik transplantologii i iskusstvennyh organov. Tom XIV. Prilozhenie. Materialy VI Vserossijskogo s’ezda trans- plantologov. M., 2012: 246.
13. Попцов В.Н., Спирина Е.А., Пчельников В.В., Иль- ин Д.С., Ильинский В.А., Потапенко И.Д., Ухрен- ков С.Г., Кугунева Н.А. Периоперационный период при трансплантации сердца с выраженной гипертро- фией миокарда левого желудочка // Вестник транс- плантологии и искусственных органов. 2012; 14 (2): 6–15.
14. Popcov V.N., Spirina E.A., Pchel'nikov V.V., Il'in D.S., Il'inskij V.A., Potapenko I.D., Uhrenkov S.G., Kugune- va N.A. Perioperacionnyj period pri transplantacii serdca s vyrazhennoj gipertrofiej miokarda levogo zheludoch- ka // Vestnik transplantologii i iskusstvennyh organov. 2012; 14 (2): 6–15.
15. Goldstein D.J., Aaronson K., Michler R.E. Mitral val- ve replacement and tricuspid valve repair following cardiac transplantation // Ann. Thorac. Surg. 1997; 63:
16. –123.
17. Laks H., Gates R.N., Ardehali A., Capouya E.R., Morigu-
18. chi J.D., Kobashigawa J.A., Stevenson L.W. Orthotopic heart transplantation and concurrent coronary bypass // J. Heart Lung Transplant. 1993; 12: 810–815.
19. Rao J.N., Prendergast B., Dark J.H. Orthotopic heart transplantation with concurrent aortic valve replacement and coronary artery bypass grafting // J. Heart Lung Transplant. 2000; 19: 897–899.
20. Larobina M. E., Mariani J. A., Rowland M.A. Aortic val- ve replacement for aortic stenosis during orthotopic car- diac transplant // Ann. Thorac. Surg. December 1, 2008; 86 (6): 1979–1982.
21. Massad M.G., Smedira N.G., Hobbs R.E., Hoercher K., Vandervoort P., McCarthy P.M. Bench repair of the do- nor mitral valve before heart transplantation // Ann. Tho- rac. Surg. 1996; 61: 1833–1835.
22. Michler R.E., Camacho D.R. Ex-vivo mitral valve repair prior to orthotopic cardiac transplantation // Ann. Tho- rac. Surg. 2002; 73: 962–963.
23. Risher W.H., Ochsner J.L., Van Meter C. Cardiac trans- plantation after donor mitral valve commissurotomy // Ann. Thorac. Surg. 1994; 57: 221–222.
24. Forni A., Luciani G.B., Chiominto B., Pilati M., Mazzuc- co A., Faggian G. Impact of donor quality on outcome of heart transplantation // Eur. J. Cardiothorac, Surg. De- cember 1, 2010; 38 (6): 788–794.
Review
For citations:
Gautier S.V., Saitgareev R.S., Poptsov V.N., Shumakov D.V., Akopov G.A., Zakharevich V.M., Kormer A.Y., Spirina E.A. DONOR HEART VALVES RECONSTRUCTION BEFORE TRANSPLANTATION. Russian Journal of Transplantology and Artificial Organs. 2013;15(2):36-43. (In Russ.) https://doi.org/10.15825/1995-1191-2013-2-36-43
Views:
1397
Email this article 