Abstract
Objective – to analyze the evolution of approaches to implantation and processing of frameless mitral allograft from the first experiments using cryopreserved allografts to modern concepts of repopulation and decellularization in order to create a single valve framework for growing a “new native valve” on its basis.
Data from Google and PubMed search engines for the queries: “mitral homograft”, “mitral allograft”, “homotransplantations of the mitral valve”, “homograft mitral valve replacement” and others has been analyzed.
This part of the study describes the 2nd and 3rd period: (from 1987 to 2007) – from the invention of a gentle method of biotissue cryopreservation to the successful use of viable stenkess mitral allograft (SMA) for atrioventricular prosthetics in the clinic; the 3rd period (from 2007 to the present) – the improvement of old techniques and the search for new ways to manufacture SMA, their devitalization and subsequent use in the clinic for revitalization. The role of viability preservation in extending the functioning time of SMAs is noted, and various approaches to increasing the reliability of surgical techniques are analyzed. The modern concept of SMA repopulation acceleration, i.e. creation of conditions for formation of a new native valve on the basis of SMA, is reported. L.A. Bokeria, D.V. Britikov and a group of scientists and surgeons from the A.N. Bakoulev National Medical and Research Center of Cardiovascular Surgery were among the first in the world to substantiate this idea in 2007, and in 2017 it was developed by the development of the method of "hybrid decellularization", supplemented with the use of cross-linking agents and "seeding" of the recipient's cells. A.N. Bakulev NMIACCS (Moscow, Russia).
The current trend is to create an immunologically inert, but sufficiently durable SMA framework, on the basis of which a "new native valve" will be re-formed. One of the methods to achieve this goal is decellularization treatment of allografts. Our compatriots take the leading position in this direction.
References
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About the authors
- Leo A. Bockeria, Academician of the Russian Academy of Sciences, President of Center; ORCID
- Anton V. Tsaregorodtsev, Student; ORCID
- Dmitriy V. Britikov, Dr. Med. Sci., Leading Researcher; ORCID
- Sergey P. Glyantsev, Dr. Med. Sci., Professor, Chief Researcher; ORCID
