Pulmonary arterioplasty with decellularized allogeneic patches
Richard A Hopkins1, Gary K Lofland1, Jennifer Marshall1
1The Children's Mercy Hospital, The Ward Family Heart Center, Kansas City, Missouri.
The Annals of Thoracic Surgery
|February 5, 2014
Summary
New decellularized pulmonary artery patches show promising midterm results for congenital heart repair. These patches demonstrated superior durability compared to traditional materials, with no failures or reoperations reported.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Pediatric Cardiology
Background:
- Decellularized allogeneic pulmonary artery patches represent an emerging alternative to conventional materials for arterioplasty.
- Existing options include cryopreserved allografts, xenogeneic bioprosthetics, and synthetic materials, each with limitations.
Purpose of the Study:
- To evaluate the midterm clinical performance of a novel decellularized allogeneic pulmonary artery patch (MatrACELL) in congenital cardiac reconstructions.
- To compare the outcomes of these new patches with historical data from cryopreserved allografts and synthetic materials.
Main Methods:
- A prospective, nonrandomized, observational study included 108 patients undergoing cardiovascular reconstructions with 120 decellularized patches between 2009 and 2012.
- Pulmonary arterioplasties were performed in 100 patients; outcomes were compared to a retrospective cohort of 100 patients who received traditional patches.
- Data collected included demographics, surgical outcomes, reoperations, and catheter interventions.
Main Results:
- No device-related serious adverse events, device failures, or calcifications were observed in 106 patients receiving 118 decellularized patches.
- In contrast, the historical cohort experienced a 14.0% patch failure rate requiring reoperation.
Conclusions:
- Decellularized pulmonary artery patches demonstrate favorable intermediate-term performance in congenital cardiac reconstructions.
- The study indicates no material failures or device-related reoperations, suggesting improved durability over traditional patch materials.
