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Ventricular septal aneurysm after atrioventricular septal repair with pericardium
H M Burkhart1, S A Moody, G J Ensing
1Department of Surgery, Indiana University Medical Center, Indianapolis 46202, USA.
Insights
Untreated autologous pericardium is unpredictable for repairing large congenital ventricular septal defects. This case highlights the risks, showing a symptomatic aneurysm requiring surgical removal.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomaterials Science
Background:
- Atrioventricular septal defects (AVSDs) are congenital heart conditions requiring surgical repair.
- Autologous pericardium is a biomaterial sometimes used in cardiac defect repair.
- Type C AVSDs involve a complete absence of the atrioventricular septum.
Observation:
- A 2-month-old infant with a type C AVSD underwent a two-patch repair using untreated autologous pericardium.
- Months post-surgery, the infant developed a large, symptomatic aneurysm at the ventricular septal patch site.
- The aneurysm necessitated surgical resection.
Findings:
- Untreated autologous pericardium demonstrated unpredictable behavior when used for large congenital ventricular septal defects.
- The development of a symptomatic aneurysm indicates a potential failure mode of this biomaterial in this context.
Implications:
- The use of untreated autologous pericardium for large congenital ventricular septal defects should be approached with caution and potentially avoided.
- Further research into the long-term durability and safety of autologous pericardium for complex pediatric cardiac repairs is warranted.
- Alternative or treated biomaterials may offer more predictable outcomes for these challenging pediatric cardiac surgeries.
Abstract:
A 2-month-old infant underwent a two-patch repair of a type C atrioventricular septal defect using autologous pericardium. Several months later a large, symptomatic aneurysm of the ventricular septal patch developed, requiring resection. The use of untreated autologous pericardium for large, congenital ventricular septal defects is unpredictable and should be avoided.