Glutaraldehyde-fixed bovine pericardium for right ventricular outflow enlargement

Right ventricular outflow tract enlargement using glutaraldehyde-fixed bovine pericardium was evaluated experimentally using the pig model. Twelve piglets (8-16 kg) underwent closure of surgically created, longitudinal right ventriculotomies using premeasured, round, bovine pericardial patches. Half of the animals had pulmonary artery banding to increase right sided pressures. The animals were studied an average of 5.1 months following surgery. Cardiac catheterization was performed on eight animals. Pressure measurements revealed no gradient across any outflow patch, and angiography showed no stenosis or dilatation. There was marked right ventricular hypertension in the banded animals. The hearts from all twelve animals were examined grossly and microscopically. There was endothelialization of all patches with no aneurysm formation. Measurements revealed that most patches had become oval shaped. There was no difference in patch size changes between banded and non-banded animals. The patches showed no significant size change in the longitudinal plane (average from 20.8 mm to 20.3 mm, 6.3% change); however, there was a significant decrease in the transverse size (20.8 mm to 17.3 mm, 16.0%) (p less than 0.001). The change in patch size was probably due to reshaping to conform to the longitudinal ventriculotomy and caused no narrowing. In this study, glutaraldehyde-fixed bovine pericardium appeared to be satisfactory for right ventricular outflow enlargement. Favorable qualities include ease of handling, hemostasis, and no aneurysm formation.