This type of surgery is performed on patients who suffer from valvular stenosis or valvular insufficiency, congenital defects, infection, cardiomyopathy, hypertension, and heart attacks. Three types of tissue valves are used in valve surgery, including pig tissue (porcine), cow tissue (bovine), and human (allografts or homografts). Some valves combine mechanical parts with the tissue, and some are totally mechanical.
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The bone and musculoskeletal transplant program includes adult and pediatric orthopaedics, sports medicine, spine/neurology, limb salvage and bone and soft tissue tumors.
Adult and Pediatric Orthopaedics:
Adult and pediatric procedures are performed to address trauma, bone healing problems and congenital deformities. Cleveland Clinic performs large bone replacements for reconstruction after cancer resection to create a structural support, as well as performs procedures for large segment allografts for extremity limb salvage for tumors and trauma. The adult and pediatric services use donor bone to fill in defects and loose bone from fractures and joint replacement for support. The pediatric service uses allograft tissue that is size-matched with the recipient with the intent that the allograft eventually will be replaced by normal living host tissue.
Many sports injuries occur to the soft tissue of the knee and ankle. These injuries can be surgically repaired using tendons and ligaments from a tissue donor. These soft tissues can also be used in partial or total joint replacement. Tissue is also used in repairing rotator cuff injuries.
Cleveland Clinic offers a fresh-tissue osteochondral allograft program for cartilage defects in the knee, which is dependent on the availability of osteochondral grafts supplied by Lifebanc. This area also performs autologous cell-cultured chondrocyte transplantation for cartilage surface defects of the knee, as well as allograft meniscal transplants and bone-tendon-bone allografts for anterior cruciate ligament (ACL) knee repairs. About 30,000 of these surgeries are done every year with allograft tissue.
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Cleveland Clinic spine surgeons are experienced in the surgical management of spinal disorders, including spinal stenosis, disc herniation, spinal tumors, spinal trauma, scoliosis and other complex deformities and disorders of the cervical, thoracic and lumbar spine. These disorders may require bone transplants to help alleviate pain and enhance the patient’s quality of life.
Glickman Urological and Kidney Institute utilizes tissue as a treatment option for incontinence and for the reinforcement of soft tissue after surgery. Tissue allografts also are used in urethroplasties and pubovaginal sling procedures.
The Institute’s Department of Colorectal Surgery utilizes tissue in some specialized procedures, including anal fistulas repair using a tissue plug and ventral hernia repair.
The Department of Vascular Surgery performs more than 2,000 procedures each year and frequently uses tissue allografts for repair and reconstruction of weak or severely diseased blood vessels. One-third of all the procedures performed by Vascular Surgery are for atherosclerosis, peripheral arterial disease and peripheral vascular disease. Other conditions treated surgically include aneurysms, carotid artery disease and venous disease.
The Department of Dentistry utilizes tissue in the surgical repair of extraction sockets and periodontal defects and in the setting of dental implants. Bone allografts in these procedures promote additional bone growth to strengthen the various implants used.
The Department of Plastic Surgery uses tissue, primarily skin grafts, for a variety of procedures and surgeries. Some include facial cosmetic surgery, reconstruction of pediatric craniofacial defects, wound coverage and cosmetic and reconstructive breast surgery. Skin grafts are widely used in surgery for wound closure in mastectomies, repair of cleft palate and other facial defects, rhinoplasty and general surgery applications. In 2008, Cleveland Clinic surgeons performed the world's first near-total face transplant in U.S. history.
Andrology and In Vitro Fertilization
The Cleveland Clinic Andrology Laboratory and Reproductive Tissue Bank, which has provided therapeutic sperm banking services since 1980, conducts sperm counts and a variety of tests on semen. The Cleveland Clinic Fertility Center, in the Department of Obstetrics and Gynecology, offers a wide range of procedures, such as in vitro fertilization (IVF), intracytoplasmic sperm injection, sperm aspiration, assisted hatching, blastocyte transfer and embryo cryopreservation, as well as egg and sperm donation and an IVF surrogate program.