[Repair of ventricular septal defects with pericardial xenografts in infants]

The article deals with the experience in the clinical use of pericardial xenografts in surgical correction of large ventricular septal defects in babies. Primary closure of the VSD under conditions of hypothermic perfusion at a low volume rate was carried out in 202 children whose ages ranged from 6 weeks to 12 months and body weight from 3.5 to 10 kg. The aorta was not clamped. In 142 patients the defect was closed with xenogenous pericardium treated with 0.6% glutaraldehyde solution on HEPE buffer and 1% sodium dodecyl sulfate solution. A pericardial xenograft treated by Carpantje's method was used before 1985 (59 patients). The hospital mortality rate was 6.4% (13 patients). The mortality rate was 5.1% among patients over 6 months of age and 11% among those under 6 months of age, which is explained by their initially extremely grave condition. The long-term results were studied in 133 patients by bidimensional and Doppler echocardiography. The pressure in the right ventricle was found to be normal (26 +/- 4.3 mm Hg) in all patients. The right- and left-ventricular end-diastolic volumes were normal, just like the ejection fractions (55.4 +/- 6.6 and 57.3 +/- 6.8%, respectively). A small escape of blood at the level of the graft was found in only 5% of patients. Mild incompetence of the tricuspid valve without clinical manifestations was revealed in 18% of patients. In none of the cases, signs of calcinosis or aneurysm of the graft were found, fatal outcomes in the long-term postoperative periods were not encountered.(ABSTRACT TRUNCATED AT 250 WORDS)