Mid-term performance of decellularized equine pericardium in congenital heart surgery.
Abstract: The aim was to report mid-term performance of decellularized equine pericardium used for repair of various congenital heart defects in the pediatric population. Methods: A retrospective review of all patients undergoing patch implantation between 2016 - 2020 was performed. Patch quality, surgical handling, hemostasis and early patch-related complications were studied on all patients. Mid-term performance was observed in patients with ≥12 months follow-up and intact patch at discharge (without reoperation/stent implantation). Results: A total of 201 patients with median age of 2.5 years [interquartile range (IQR): 0.6-6.5] underwent 207 procedures at 314 implant locations. The patch was used in following numbers/locations: 171 for pulmonary artery (PA) augmentation, 36 for aortic repair, 35 for septal defect closure, 22 for valvular repair and 50 at other locations. Early/30-day mortality was 6.5%. Early patch-related reoperations/stent implantations occurred in 28 locations (8.9%). No patch-related complications were noted except for bleeding from implant site in three locations (1%). Follow-up ≥ 12 months was available for 132 patients/200 locations. During a median follow-up of 29.7 months [IQR: 20.7-38.3], 53 patch-related reoperations/catheter reinterventions occurred (26.5%) with the majority in PA position (88.7%, 47/53). Overall 12- and 24-months freedom from patch-related reoperation/catheter reintervention per location was 91.5% (95% CI: 86.7%-94.6%) and 85.2% (95% CI: 78.9%-89.6%) respectively. Conclusions: Decellularized equine pericardium used for repair of various congenital heart defects showed acceptable mid-term performance. Reoperation/reintervention rates were in a range as observed with other xenogeneic materials previously reported articles, occurring most frequently after PA augmentation.
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
Publication Date: 2022-11-07 PubMed ID: 36342192DOI: 10.1093/icvts/ivac269Google Scholar: Lookup
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- Journal Article
Summary
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This research assesses the effectiveness of using decellularized equine pericardium (tissue from the heart’s lining) in pediatric patients needing heart defect repairs. It provides information on the mid-term performance, including complication rates and success in different implant locations.
Research Methodology
- The researchers conducted a retrospective review, meaning they looked back on past patient records and results, of all patients who received a patch implantation between 2016 and 2020.
- The study examined the quality of the patch, how well it could be handled during surgery, how effective it was in stopping bleeding (hemostasis), and any complications arising soon after the surgery that were related to the patch.
- The research also examined the mid-term performance of the patch in those patients who had a follow-up of 12 months or more post-surgery and had no need for further operations or stent implantations.
Results
- In total, 201 patients underwent 207 procedures at 314 implant locations.
- The majority of patches were used for augmenting the pulmonary artery (171 patches), with other common uses being aortic repairs (36 patches), septal defect closures (35 patches), valve repairs (22 patches), and other locations (50 patches).
- The early mortality rate (within 30 days post-surgery) was 6.5%, and about 8.9% of patients needed a reoperation or stent implantation due to issues with the patch.
- Only three instances (1%) of bleeding from the implant site were found to be related to the patch.
- At the 12-month mark or more post-surgery, 53 out of 200 cases needed a reoperation or catheter reintervention due to the patch, with most of these instances occurring after pulmonary artery augmentation.
Conclusions
- Overall, the study found that the use of decellularized equine pericardium for repairing various congenital heart defects showed results that can be considered good for the mid-term follow-up period.
- The rates of reoperations or reinterventions required due to the patch were within the range observed with the use of other xenogeneic materials (those derived from different species), according to previously reported articles.
Cite This Article
APA
Weixler VHM, Kuschnerus K, Romanchenko O, Ovroutski S, Cho MY, Berger F, Sigler M, Sinzobahamvya N, Photiadis J, Murin P.
(2022).
Mid-term performance of decellularized equine pericardium in congenital heart surgery.
Interact Cardiovasc Thorac Surg, ivac269.
https://doi.org/10.1093/icvts/ivac269 Publication
Researcher Affiliations
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany.
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany.
Citations
This article has been cited 5 times.- Marathe SP. Commentary: the ideal patch material for congenital cardiac surgery: one ring to rule them all?. Interdiscip Cardiovasc Thorac Surg 2023 Mar 2;36(3).
- Sun M, LaSala VR, Giuglaris C, Blitzer D, Jackman S, Ustunel S, Rajesh K, Kalfa D. Cardiovascular patches applied in congenital cardiac surgery: Current materials and prospects. Bioeng Transl Med 2025 Jan;10(1):e10706.
- Tiwari N, Kumar A, Ramamurthy HR, Kumar V, Khare A. Tissue engineered decellularized bovine pericardium as prosthetic material in paediatric cardiac surgery. Indian J Thorac Cardiovasc Surg 2025 Jan;41(1):35-40.
- Watanabe T, Yuhara S, Leland JT, Spiess JL, Thodla A, Ramachandiran R, Kelly JM, Shinoka T, Breuer CK. Ectopic Calcification in Congenital Heart Surgery: A Material-Centric Review. Pediatr Cardiol 2025 Oct;46(7):1771-1789.
- Eildermann K, Durashov M, Kuschnerus K, Poppe A, Weixler V, Photiadis J, Sigler M, Murin P. Tissue-engineered and autologous pericardium in congenital heart surgery: comparative histopathological study of human vascular explants. Eur J Cardiothorac Surg 2024 Mar 1;65(3).
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