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Long-Term Follow-Up of Pericardium for the Ventricular Component in Atrioventricular Septal Defect Repair

Rinske J IJsselhof1, Saniyé D R Duchateau1, Rianne M Schouten2

  • 1Division of Pediatrics, Department of Pediatric Cardiac Surgery, 8124University Medical Center Utrecht, the Netherlands.

World Journal for Pediatric & Congenital Heart Surgery
|November 9, 2020
PubMed

Insights

Fresh untreated autologous pericardium and treated bovine pericardium are safe for ventricular septal defect closure in atrioventricular septal defect repair. Both materials showed no significant difference in left atrioventricular valve function or reoperation rates.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomaterials in Medicine

Background:

  • Complete atrioventricular septal defect (AVSD) repair outcomes have improved, yet reoperations for left atrioventricular valve (LAVV) dysfunction remain frequent.
  • Evaluating alternative materials for ventricular septal defect (VSD) closure is crucial to optimize AVSD repair outcomes.

Purpose of the Study:

  • To assess the impact of fresh untreated autologous pericardium versus treated bovine pericardial patch material for VSD closure on subsequent LAVV function.
  • To compare the long-term efficacy and safety of these two patch materials in AVSD repair.

Main Methods:

  • A retrospective analysis of clinical and echocardiographic data from 77 patients with complete AVSD who underwent VSD closure between 1996 and 2003.
  • Patients received either untreated autologous pericardium or treated bovine pericardial patch for VSD closure, with follow-up extending to September 2019.

Main Results:

  • A total of 77 patients were analyzed, with 59 (77%) receiving autologous pericardium and 18 (23%) receiving bovine pericardium.
  • Median follow-up was 17.5 years; two early deaths (3%) occurred. Reinterventions were necessary in eight patients, all within the autologous pericardium group.
  • Log-rank tests revealed no significant differences in mortality (P=.892), LAVV reinterventions (P=.228), or LAVV regurgitation (P=.770) between the groups.

Conclusions:

  • Both untreated autologous pericardium and xeno-pericardium (bovine pericardium) are safe options for VSD closure in AVSD repair.
  • There was no discernible difference in the incidence of LAVV regurgitation or the requirement for reoperation between the two patch materials used.
Abstract

Keywords:
atrioventricular septal defectcongenital heart surgerymitral regurgitationreoperation

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