The broadly based pericardial flap. A tissue for atrial wall replacement that grows

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Pediatric Cardiology

Background:

• Congenital heart anomalies often require surgical repair using tissue grafts.
• Existing tissue replacements do not adequately grow with pediatric patients.
• A need exists for a pediatric-compatible tissue graft for heart repair.

Purpose of the Study:

• To investigate the growth potential of autogenous pericardial flaps and patches in vivo.
• To assess the suitability of pericardial grafts for pediatric congenital heart defect repair.
• To determine if pericardial flaps can match somatic growth in young animals.

Main Methods:

• Suturing a pericardial flap over the excised right atrial wall in 12 puppies.
• Creating an autogenous pericardial patch in 4 puppies by detaching the flap.
• Leaving pericardial flaps intact with retained neural and vascular supply in 8 puppies.
• Measuring graft size relative to body surface area (BSA) over time.

Main Results:

• Pericardial patches did not increase in size (94% of original) despite BSA increase (169%).
• Pericardial flaps significantly increased in size (214% of original) with BSA increase (199%).
• The flap size index (flap size/BSA) increased to 109%, while the patch index decreased to 54%.

Conclusions:

• Autogenous pericardial flaps demonstrate growth potential comparable to body surface area increase.
• Pericardial flaps, unlike patches, show promise as a growing tissue replacement for pediatric cardiac surgery.
• This research supports the development of living pericardial grafts for congenital heart defect repair.