Despite advances in modern surgery, congenital heart disease remains a medical challenge and major cause of infant mortality. Valved conduits are routinely used to surgically correct blood flow in hearts with congenital malformations by connecting the right ventricle to the pulmonary artery (RV-PA). This review explores the current range of RV-PA conduits and describes their strengths and disadvantages. Homografts and xenografts are currently the primary treatment modalities, however both graft types have limited biocompatibility and durability, and present a disease transmission risk. Structural deterioration of a replaced valve can lead to pulmonary valve stenosis and/or regurgitation. Moreover, as current RV-PA conduits are of a fixed size, multiple subsequent operations are required to upsize a valved conduit over a patient’s lifetime. We assess emerging biomaterials and tissue engineering techniques with a view to replicating the features of native tissues, including matching the durability and elasticity required for normal fluid flow dynamics. The benefits and limitations of incorporating cellular elements within the biomaterial are also discussed. Present review demonstrates that an alignment of medical and engineering disciplines will be ultimately required to produce a biocompatible and high-functioning artificial conduit.

中文翻译：

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当前制造肺动脉人工右心室（RV-PA）心脏导管的挑战和新兴技术。

尽管现代手术取得了进步，但先天性心脏病仍然是医学上的挑战，也是婴儿死亡的主要原因。阀门导管通常用于通过手术将右心室连接到肺动脉（RV-PA），以纠正先天性畸形心脏的血液流动。这篇综述探讨了RV-PA导管的当前范围，并描述了它们的优缺点。目前，同种异体移植和异种移植是主要的治疗方式，但是两种移植类型的生物相容性和耐久性均受到限制，并存在疾病传播的风险。更换瓣膜的结构恶化会导致肺动脉瓣狭窄和/或反流。此外，由于当前的RV-PA导管具有固定的尺寸，因此需要多次后续操作以在患者的一生中增大带阀导管的尺寸。我们评估新兴的生物材料和组织工程技术，以复制天然组织的特征，包括匹配正常流体流动动力学所需的耐久性和弹性。还讨论了将细胞元素掺入生物材料中的好处和局限性。目前的审查表明，最终需要医学和工程学科的结合才能生产出具有生物相容性和高功能的人工导管。