МОРФОФУНКЦИОНАЛЬНЫЕ ОСОБЕННОСТИ АОРТАЛЬНОГО ГРАФТА ПОСЛЕ ДЕЦЕЛЛЮЛЯРИЗАЦИИ

Purpose. The aim is to analyze the features of aortic valve allografts decellularized with trypsin solution or a combination of the sodium dodecyl sulfate/deoxycholate solution.Materials and methods. We performed histological, bacteriological and mechanical testing of graft.Results. It was found that after the removal of cellular elements with trypsin the strength of allograft significantly decreased compared with the control group and the samples exposed to detergent treatment. Histological analysis of aortic allograft specimens showed signifi cantly impaired spatial organization of the connective tissue framework of the valve after the enzymatic treatment.Conclusion. Detergent decellularization is the preferred method for obtaining cell-free aortic allografts because it can effectively remove the donor cells and maintain the microstructure and biomechanical properties of the valve graft. Цель. Анализ особенности аллографтов аортального клапана, децеллюляризованных с помощью раствора трипсина или комбинированного действия растворов додецилсульфата и дезоксихолата натрия.Материалы и методы. Проводили гистологические, бактериологические и мехнические испытания графта.Результаты. После удаления клеточных элементов трипсином достоверно снижалась прочность аллографта по сравнению с группой контроля и образцов после детергентной обработки. Гистологический анализ образцов аортальных аллографтов достоверно показал выраженное нарушение пространственной организации соединительнотканного каркаса клапана после ферментной обработки.Заключение. Детергентная децеллюляризация является предпочтительным методом получения бесклеточного аортального аллографта, т. к. позволяет эффективно удалить клетки донора и сохранить микроструктуру и биомеханические свойства графта.

ИНВАГИНАЦИЯ УШКА ЛЕВОГО ПРЕДСЕРДИЯ У РЕБЕНКА РАННЕГО ВОЗРАСТА ПОСЛЕ КОРРЕКЦИИ ДЕФЕКТА МЕЖЖЕЛУДОЧКОВОЙ ПЕРЕГОРОДКИ

The inversion of the left atrium appendage in infants is a very rare anomaly, which may occurs either after cardiac surgery. We introduce a case report of infant with left atrium appendage invagination after ventricular septal defect closure. Инвагинация ушка левого предсердия у детей раннего возраста является крайне редкой аномалией, которая возникает как после кардиохирургических операций, так и спонтанно при нарушениях ритма сердца. Мы представляем клинический случай у ребенка раннего возраста с инвагинацией ушка левого предсердия после коррекции дефекта межжелудочковой перегородки.

Stenting of the right ventricular outflow tract after thrombosis of the modified Blalock-Taussig shunt in a 8 month old infant with tetralogy of Fallot and right pulmonary artery agenesis

Pulmonary artery agenesis combined with tetralogy of Fallot is the most rarely seen congenital heart disease. Children with this anomaly are an especially problematic category of patients undergoing staged surgical repair. The postoperative period quite often is complicated with shunt thrombosis while a redo open surgery is associated with a very high risk; therefore, endovascular repair is a preferred procedure. We describe a case of right ventricular outflow tract stenting in a 8 month old girl with tetralogy of Fallot and right pulmonary artery agenesis. The patient was admitted at 3 month after performing of a left-sided modified Blalock-Taussig shunt with severe signs of heart failure and desaturation caused by shunt thrombosis. Assessments performed at 2 months after stenting of the outflow tract demonstrated good oxygen saturation in arterial blood (80% and above) and improvement of heart failure symptoms to NYHA II class

EXTRACORPORAL CARDIOPULMONARY RESUSCITATION (ECPR) FOLLOWING PULMONARY ARTERY RUPTURE IN AN INFANT

The rupture of the pulmonary artery during balloon valvular dilatation is rare and the severest complication. In this clinical case we described the rupture of the pulmonary artery in a 10-month-old baby with cardiac tamponada and an extreme hemodilution due to blood loss. CPR has been using for 40 minutes but being ineffective. For 3 days we have been applying ECMO. This patient was discharged without any neurological disorders

Bioprosthetic xenopericardium preserved with di- and penta-epoxy compounds: molecular cross-linking mechanisms, surface features and mechanical properties

Background. Heart valve bioprostheses made from glutaraldehyde-treated bovine and porcine pericardia are widely used in open and transcatheter valve surgeries. However, the glutaraldehyde cross-linkage leads to bioprosthetic calcification in many patients. Epoxides are advantageous alternatives to glutaraldehyde, since they engender the biomaterial with better calcification resistance. The cross-linking features of an epoxy compound depend on its chemical structure and have not been fully studied so far. Aim. The study is aimed at comparing the effectiveness and molecular mechanisms of biomaterial treatment using diepoxide vs pentaepoxide compounds. Methods. We studied the stability of diepoxide and pentaepoxide in water and aqueous buffered solutions, as well as the amino acid composition, type of epoxide links with collagen matrix (infrared spectroscopy) and mechanical properties of bovine and porcine pericardia treated with 5% diepoxide, a mixture of 2% diepoxide and 1% pentaepoxide, and with alternating 5% diepoxide and 2% pentaepoxide treatments. Results. Diepoxide and pentaepoxide are both stable in aqueous buffer solutions (pH 7.4). Diepoxide provides high linkage density in bovine and porcine pericardia due to reactions with the amino groups of the OHLys, Lys, His, and Arg residues, and the hydroxyl groups of OHPro, Ser, and Tyr, while pentaepoxide reacts only with Met. Pentaepoxide enhances the strength and elasticity of the xenopericardium. Specimens consecutively treated with diepoxide and pentaepoxide were significantly thinner and featured the highest maximal tensile stress, maximal strain and elastic modulus in comparison with tissues treated with 5% diepoxide and diepoxide-pentaepoxide mixture. Conclusion. The alternating diepoxide-pentaepoxide combination for biomaterial cross-linking is a promising trend for bioprosthetic pericardium treatment

Palliative reconstruction of right ventricular outflow tract by using femoral vein allograft in a newborn with hypoplastic pulmonary artery and ventricular septal defect: case report

Treating patients with pulmonary atresia and ventricular septal defect, who have hypoplastic native pulmonary arteries, is a challenge for cardiac surgeons. We have reported a case of successful pulmonary bed rehabilitation using a femoral vein allograft in a patient with pulmonary atresia and ventricular septal defect. No similar cases with a detailed description of surgery stages and pulmonary artery development supported by illustrative materials are described both in the literature. The strategy of rehabilitation of the native pulmonary artery bed facilitates antegrade pulmonary blood flow, increases native pulmonary arteries growth, contributes to successful implementation of staged endovascular interventions and allows for complete repair. The technique of “short” cardiopulmonary bypass with induced ventricular fibrillation is a safe and effective option for such patients. This clinical case might be useful in medical practice of pediatric cardiac surgeons involved in the problem of pulmonary artery rehabilitation.Received 4 June 2018. Revised 4 July 2018. Accepted 5 July 2018.Informed consent: The legal representative (infant’s mother) has voluntarily given her written informed consent to use the infant’s medical data obtained in the course of treatment for scientific purposes and for their publication.Funding: The study had no sponsorship.Conflict of interest: Authors declare no conflict of interest.</p