Evaluation of Explanted CorMatrix Tyke Extracardiac Patches in Infants With Congenital Heart Disease

Wharton's Jelly-Mesenchymal Stem Cell-Engineered Conduit for Pulmonary Artery Reconstruction in Growing Piglets

Surgical treatment of congenital heart defects affecting the right ventricular outflow tract often requires complex reconstruction and multiple reoperations. With a randomized controlled trial, we compared a novel tissue-engineered small intestine submucosa-based graft for pulmonary artery reconstruction (seeded with mesenchymal stem cells derived from Wharton's Jelly) with conventional small intestine submucosa in growing piglets. Six months after implantation, seeded grafts showed integration with host tissues at cellular level and exhibited growth potential on transthoracic echocardiography and cardiovascular magnetic resonance. Our seeded graft is a promising biomaterial for pulmonary artery reconstruction in pediatric patients with right ventricular outflow tract abnormalities.

Prospects for prevention of adhesion process during cardiac surgical interventions

The article is devoted to the problem of prevention of adhesions in cardiac surgery. It was determined that the problem is urgent due to the increase in the number of heart surgeries. The formation of adhesions is a reaction of the body after surgery, which is a stage of healing and partly performs a protective function. Nevertheless, the presence of adhesions violates the mechanical properties of the heart, negatively affects central hemodynamics, complicates the surgeon’s task during repeated surgical interventions and increases the risk of repeated operations.It has been shown that at present, for the prevention of adhesions, researchers tend to use biodegradable barrier materials with biocompatibility and the ability to dissolve after performing the barrier function. The main anti-adhesion agents used in cardiac surgery are membranes and gels. The requirements for an “ideal” agent for the prevention of adhesion were determined: biocompatibility, no irritating effect, no effect on wound healing, suppression of the growth of connective tissue in the pericardium.Conclusions. Until now, none of the funds has all the necessary qualities to prevent adhesion in the pericardium. Therefore, the search for effective methods for the prevention of postoperative adhesions remains relevant for cardiac surgery.

Considerations in the Surgical Management of Unicuspid Aortic Stenosis

Unicuspid aortic valve (UAV) stenosis is a rare condition accounting for 5% of non-rheumatic aortic stenosis. The diagnosis can be difficult to make prior to surgical intervention and transesophageal echocardiography has been demonstrated to be more accurate in making the diagnosis compared to transthoracic echocardiography. The presence of a posteriorly located aortic orifice on the short-axis views, with one or two visible raphe anteriorly; the absence of commissures (acommissural); or the presence of a lone commissure (unicommissural) between the left and noncoronary, or the left and right cusps suggests the diagnosis. Patients with UAV are predominantly males and present with stenosis about a decade earlier than those with the more prevalent bicuspid aortic valves (BAV). They more commonly present with aortic annular dilatation and have fewer comorbidities at presentation compared to patients with BAV. Surgical management of UAV stenosis includes aortic valve replacement through standard open heart surgery or percutaneous transcatheter aortic valve replacement (TAVR), aortic valve repair either by bicuspidization, tricuspidization or trileaflet reconstruction, or the Ross procedure. Patients with UAV stenosis require less concomitant coronary or other cardiac procedures when they need surgical intervention, but are about a decade younger at the time of their death. UAV stenosis is a distinct congenital anomaly with a different natural course than BAV. Surgical management should be individualized based on the patient's age at presentation, aortoannular anatomy, and associated cardiac conditions.