Results of a tissue engineered pulmonary valve in humans assessed with CMR
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BioMed Central
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Results of a tissue engineered pulmonary valve in humans assessed with CMR Carsten Rickers*1, Andreas Entenmann1,2, Gunther Fischer1, Jens Scheewe1, Michael Scheid1, Michael Jerosch-Herold3, Jan Braesen1, Inga Voges1, Chris Hart1 and Hans-Heiner Kramer1 Address: 1University Hospital Schleswig-Holstein, Kiel, Germany, 2Universtiy Hospital Kiel, Kiel, Germany and 3Department of Radiology, Brigham & Women's Hospital & Harvard Medical School, Boston, MA, USA * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P17
doi:10.1186/1532-429X-12-S1-P17
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P17 © 2010 Rickers et al; licensee BioMed Central Ltd.
Introduction Tissue-engineered (TEng) valves have recently been developed as an alternative to pulmonary valve replacement with homograft conduits to improve device life-time and function.
using an ECG triggered 3D inversion recovery sequence (TR/TE/α= 3.7 ms/1.8 ms/15°; voxel size 1.17 × 1.27 × 10 mm) and T1 and T2 weighted turbo spin echo sequences were utilized.
Results Purpose To evaluate with advanced CMR techniques the morphological and functional properties of a decellularized porcine xenograft valve conduit (Matrix-P™) and its successor product with additional equine pericardium sheathing (Matrix-P-Plus™; AutoTissue, Germany).
Methods TEng valves had been implanted into the right ventricular outflow tract of 12 pts (age: 15 ± 8,5 yrs; Matrix-P™ n = 7; Matrix-P-Plus™ n = 5) due to pulmonary stenosis or insufficiency within a median 5 months range (2-7 months) before a comprehensive follow-up by CMR. Echocardiography was suspicious of accelerated blood flow in the main pulmonary artery in 10 of those. The severity of the pulmonary valve stenosis was assessed by gradient echo cine MRI (FOV 270 × 270 mm, voxel size 1.88 × 1.94 × 5 mm, TR/TE/α = 4.4 ms/2.7 ms/15°) and phase-contrast velocity mapping (FOV 270 × 270 mm, voxel size 1.64 × 1.4 × 7 mm, TR/TE/α = 15 ms/2.5 ms/30°, velocity encoding (VENC) = 400 cm/s) were applied. For tissue characterisation late enhancement imaging (Gd 0.1 mmol/kg)
In 9 pts (33%) CMR detected a significant conduit stenosis (Vmax 3.7 ± 1,3 m/s) with mild or moderate insufficiency (RGF 21.3 ± 5.9%) post-surgery. In 3 pts the conduit was considered to be normal. In all pts with a stenosis, T1-weighted images showed significant paravalvular Gadolinium enhancement and wall thickening of the conduit. In 7 pts the "Matrix" valve conduit was replaced by a homograft. Explants were evaluated through histological analysis that showed granulomatous inflammation and increased fibrous tissue content correlating wi
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