Restoring the heart saves lives
Angela Irizarry from Bridgeport, Connecticut, was born in November 2007 with one of the most serious life–threatening birth defects – Raufus-Kisel syndrome (hypoplasia of the left half of the heart). In this syndrome, the left half of the heart does not develop, including the aorta, aortic valve, left ventricle and mitral valve. Blood from the lungs flows through an opening in the atrial septum and when the right ventricle contracts, it enters the aorta through an open arterial duct. Without surgical intervention, 70% of such children die in the first year of life.
Over the past decades, surgeons have learned to save the lives of such children by implanting a synthetic vessel in the place where the left ventricle should be. This improves the quality of life of patients, but the artificial nature of the vessel causes a number of complications, including thrombosis, infection and rejection. In addition, such an implant cannot grow together with the child's body. Angela underwent two such operations: at the age of 5 days and 8 months.
For the first time, the idea of creating a transplant from a patient's own cells was expressed by Toshi Shinoka, a pediatric cardiac surgeon from Yale University, who developed the first version of the procedure and operated on more than two dozen patients in Japan.
Dr. Shinoka joined forces with pediatric surgeon Christopher Breuer and a group of bioengineering specialists working under the guidance of Professor Mark Saltzman, resulting in the improvement of the procedure, which in November 2009 received the approval of the U.S. Food and Drug Administration for clinical trials.
The procedure consists in the isolation of stem cells from the patient's bone marrow, which are sown on a biodegradable frame in the form of a tube. This structure is incubated for several hours, after which it is implanted into the patient.
The developers believed that the cells sown on the frame would form the blood vessel tissue in the form of a vessel. However, to their surprise, it turned out that over time they, as well as the skeleton, completely disappear from the implantation site, and a new vessel is formed due to the activation of proliferation and differentiation of cells of surrounding tissues.
After numerous training sessions in the laboratory and conversations with the families of potential patients, the specialists made their choice, and the operation of Angela Irizarry was scheduled for August 2011. The only complication was an infection, because of which Angela stayed in the clinic for two weeks instead of the planned one.
In November 2011, the girl celebrated her 4th birthday and now she can, like a normal child of her age, tirelessly run and ride a bike. Unfortunately, due to the inferiority of the immune system, she cannot yet attend children's institutions. The problem is that, among other problems, she was born without a spleen. However, doctors hope that Angela's body will adapt and she will be able to lead a completely normal life.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of Medical Xpress: Rebuilding a heart, saving a life.
17.04.2012