Effects of a newly designed pediatric pulmonary heart valve on hemodynamic function

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K17731
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55030:Cardiovascular surgery-related
• Research Institution: Nippon Medical School
• Principal Investigator: Suzuki Kenji 日本医科大学, 医学部, 講師 (20623341)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 先天性心疾患 / チアノーゼ / 弁付き人工血管 / 右室流出路再建

Outline of Final Research Achievements

In right ventricular outflow tract reconstruction using a pulmonary valved conduit for congenital heart disease, post-implantation thrombus formation and reduced mobility of the valve leaflet due to adherence of thrombus cause narrowing of the conduit, resulting in valve dysfunction in some cases. We developed an ePTFE bicuspid valved conduit that opens when the valve leaflet folds toward the center in systolic phase and closes when the valve leaflet widens and adheres to the wall of the conduit in diastolic phase.
The pressure range was comparable to that of a bio-imitated tricuspid valved conduit, and the regurgitation rate was lower in the developed bicuspid valve conduit, which was comparable to that of a bio-instrumental valve made by a company. The results indicated that valve function could be improved by modifying the valve leaflet and conduit geometry.

Free Research Field

先天性心疾患外科治療

Academic Significance and Societal Importance of the Research Achievements

右室流出路再建術に用いられる肺動脈弁付き人工血管は、植え込み後血栓形成や器質化血栓の固着による弁葉の可動性低下により血流路の狭窄が生じ、結果的に弁機能不全に陥る症例も散見される。機能不全に陥った場合は新たな肺動脈弁付き人工血管への交換が必要となり、結果として患児が受ける開心術の回数が増加することとなる。幼少期の患児に与える影響は甚大であり、これを回避することが我々小児医療に関わる者の責務であると考えられる。本研究により弁付き人工血管の機能不全の回避および長期成績の向上につながる知見が得られた。これは先天性心疾患研究に与える影響は極めて大きく、非常に社会的意義のあることである。