In Vivo Feasibility and Growth of Atrioventricular Partial Heart Transplantation in a Porcine Model.
| Title: | In Vivo Feasibility and Growth of Atrioventricular Partial Heart Transplantation in a Porcine Model. |
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| Authors: | Wolf SEM; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Kucera JA; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Ngeve SM; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Aykut B; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Ghandour HZ; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Miller SG; Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA.; Turek JW; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Duke Children's Pediatric and Congenital Heart Center, Durham, NC, USA.; Overbey DM; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC, USA.; Duke Children's Pediatric and Congenital Heart Center, Durham, NC, USA. |
| Source: | Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2025 Sep-Oct; Vol. 20 (5), pp. 432-434. Date of Electronic Publication: 2025 Oct 13. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: SAGE Publications Country of Publication: United States NLM ID: 101257528 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-0879 (Electronic) Linking ISSN: 15569845 NLM ISO Abbreviation: Innovations (Phila) Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2019- : [Thousand Oaks, CA] : SAGE Publications; Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins |
| MeSH Terms: | Heart Transplantation*/methods ; Mitral Valve*/surgery ; Mitral Valve*/growth & development; Animals ; Swine ; Feasibility Studies ; Echocardiography ; Disease Models, Animal ; Models, Animal |
| Abstract: | Objective: Pediatric mitral valve replacement remains a significant challenge due to the lack of growth-capable prostheses, often necessitating multiple reoperations. Partial heart transplantation (PHT) has shown promise in the semilunar position but has not been studied in the atrioventricular (AV) position. This study evaluates the feasibility and growth potential of AV PHT in an in vivo porcine model.; Methods: Three Yorkshire piglets underwent AV PHT, with the donor mitral valve implanted into the tricuspid position due to animal intraoperative tolerance limitations. The first 2 animals were used to refine surgical technique. The third piglet was designated for 2-month survival with serial echocardiographic monitoring. Donor valves were procured on the day of surgery to minimize ischemic time. Postoperative immunosuppression included tacrolimus, mycophenolate mofetil, and methylprednisolone.; Results: The survival animal tolerated the procedure well and remained clinically stable. Echocardiography demonstrated significant growth of the PHT mitral annulus from 2.0 cm to 4.3 cm, compared with 2.4 cm to 3.0 cm in the native annulus. The length of the PHT leaflet increased from 1.3 cm to 2.4 cm, whereas the length of the native leaflet increased from 1.1 cm to 1.9 cm. Nonprogressive moderate regurgitation was observed without stenosis. Gross examination confirmed excellent tissue integration without calcification or fibrosis.; Conclusions: This study demonstrates the in vivo feasibility and growth potential of AV PHT, representing a promising step toward growth-capable valve replacement for pediatric patients with irreparable mitral valve disease. |
| Competing Interests: | Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Joseph W. Turek is an equity stakeholder in Surge Ingenuity, Inc. The other authors do not have any conflicts of interest to report. |
| Contributed Indexing: | Keywords: adaptive valve growth; atrioventricular valve; mitral valve replacement; partial heart transplantation |
| Entry Date(s): | Date Created: 20251030 Date Completed: 20251030 Latest Revision: 20260425 |
| Update Code: | 20260425 |
| DOI: | 10.1177/15569845251384564 |
| PMID: | 41166085 |
| Database: | MEDLINE |
Journal Article