Efficacy of an Extracellular Matrix in Systemic Loading Conditions in Congenital Heart Surgery
| Autor: | Mohammad S. Soroya, Ryan Ou, Adeel Ashfaq, Brian Reemtsen, Amit Iyengar, Oh Jin Kwon, Son Nguyen |
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| Rok vydání: | 2017 |
| Předmět: |
Aortic arch
Aortic valve Heart Defects Congenital Male Reoperation medicine.medical_specialty Heart disease medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Aortic valve repair Postoperative Complications medicine.artery Internal medicine Mitral valve Ascending aorta medicine Humans Cardiac Surgical Procedures Retrospective Studies Mitral valve repair business.industry Graft Survival Infant medicine.disease Cardiac surgery Surgery Extracellular Matrix Survival Rate medicine.anatomical_structure Treatment Outcome 030228 respiratory system Echocardiography Pediatrics Perinatology and Child Health cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Pediatric cardiology. 38(7) |
| ISSN: | 1432-1971 |
| Popis: | Extracellular matrices (ECM) are commonly used to repair congenital heart defects; however, there is a lack of literature pertaining to outcomes with ECM use in high-pressure conditions. Between 2011 and 2014, a total of 202 patients underwent congenital heart disease repair using the ECM placed in a systemic pressure condition. The operative sites included: defects in the ventricular septum, mitral valve, aortic valve, ascending aorta, and aortic arch. Patients were followed and evaluated for mortality and reoperations due to loss of ECM integrity. Echocardiograms were evaluated for graft malfunction such as aneurysmal dilation, VSD formation, valve malfunction, or outflow tract obstruction. Patients were followed for an average of 1492 days (Median = 1583). Out of the 202 patients, 7 (3.5%) died due to complications unrelated to ECM, and 10 (5%) underwent reoperations due to complications of ECM integrity. Reoperations were as follows: two of 6 patients receiving aortic leaflet replacement required reoperation for leaflet failure; four of 12 patients receiving mitral valve leaflet repairs required reoperation for leaflet failure; and four of 142 patients with VSD repair required reoperation for residual shunting. The average time to reoperation was 208 days. There were no outflow tract obstructions or aneurysmal dilatations observed. This modern case series suggests that the ECM is efficacious and sustainable under systemic conditions in congenital heart defect repair. However, concerns remain about the use of ECM in aortic valve repair and infant mitral valve repair. Further studies are needed to evaluate long-term ECM integrity. |
| Databáze: | OpenAIRE |
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