MitraClipの装置を拡張した患者の病理的な治癒反応

Elena Ladich¹, Mary Beth Michaels, Russell M Jones

¹Medical Director/President, CVPath Institute, Inc, 19 Firstfield Rd, Gaithersburg, MD 20878, USA. rvirmani@cvpath.org

Circulation

|March 23, 2011

まとめ

MitraClipデバイスは優れた機械的整合性を示し,時間の経過とともに安定した繊維包装を形成します. この治癒プロセスは,ヒトの研究で観察され,組織の橋渡しを含み,構造の安定に貢献しています.

科学分野:

心血管研究に関する研究.
医療機器技術医療機器技術について
ヒストオパトロジー histopathology ヒストオパトロジー histopathology ヒストオパトロジー

背景:

内血管弁のエッジツーエッジ修復研究 (EVEREST) は,MitraClipデバイスを評価しています.
MitraClipの移植後のヒトの治癒反応は,以前は特徴づけられていなかった.

研究の目的:

MitraClipデバイスのインプラント化後のヒトのヒーリング反応を特徴づけるために.
ミトラクリップデバイスの長期的な組織学的統合を評価する.

主な方法:

50人の患者からの67個のMitraClip装置の組織学的評価.
4つのインプランテーション間隔のエクスプラントの分析:急性,亜急性,慢性,長期.

主要な成果:

急性反応:血小板 / 線維素の堆積. 亜急性反応:粒状組織と早期のパンヌス形成.
慢性反応:デバイスの腕間の組織の橋渡し. 長期的な反応:コラーゲンに富んだマトリックスと完全な繊維包装.
爆発した器具では,内臓炎,機械的磨損,骨折,または腐食の証拠は観察されていません.

結論:

MitraClipデバイスの機械的完全性は,爆発まで維持されます.
生理学的治癒の4つの異なる段階が観察されました:堆積,炎症,粒化,封じ込め.
長期にわたる繊維包装と組織ブリッジングは,構造の安定性とフライエットの連続性を高めます.

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