Lyophilized glutaraldehyde-preserved bovine pericardium for experimental atrial septal defect closure

A variety of patch materials has been used to close large atrial septal defects (ASD). Autologous pericardium and glutaraldehyde-preserved bovine pericardium are the most used. Lyophilized bovine pericardium has not been tested inside the cardiovascular system. The aim of this work was to study the behaviour and effectiveness of lyophilized glutaraldehyde-preserved bovine pericardium in ASD closure. Sixteen mongrel dogs were operated on. A 3 cm diameter atrial septal defect was created, and closed with: Group I (n=8): Lyophilized glutaraldehyde preserved bovine pericardium (LGPBP). Group II (n=8): Vascular Dacron patch. The animals were evaluated clinically, by echocardiography, macroscopically, and microscopically. Statistical analysis was done with analysis of variance (ANOVA) and Student's t-test. All the animals survived the surgical procedure and study time (6 months). Clinically all the animals displayed normal physical activity, with normal cardiac sounds. Echocardiography showed that both groups had a normal heart without intracardiac shunts, no thrombus formation, and no vegetations. Macroscopically all the animals showed good integration of the lyophilized bioprosthesis and Dacron patch. All group I animals presented a decrease of the area of the ASD in the left atrium (p<0.001 by ANOVA and Student's t-test). Microscopically, group I presented dense and well-organized collagenous tissue, areas of cartilaginous metaplasia and remnants of the lyophilized bioprosthesis (p<0.001 by ANOVA and Student's t-test). Group II showed encapsulated Dacron patch covered with collagenous tissue and cartilaginous metaplasia. In conclusion, the new lyophilized bioprosthesis is well integrated into the atrial septum, without complications and is effective for ASD closure.