Format

Send to

Choose Destination
Interact Cardiovasc Thorac Surg. 2015 Jul;21(1):40-9; discussion 49. doi: 10.1093/icvts/ivv076. Epub 2015 Apr 16.

Early and mid-term clinical experience with extracellular matrix scaffold for congenital cardiac and vascular reconstructive surgery: a multicentric Italian study.

Author information

1
Pediatric and Congenital Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padova, Italy massimo.padalino@unipd.it.
2
Pediatric and Congenital Cardiac Surgery and Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy.
3
Pediatric and Congenital Cardiac Surgery, University of Bologna Medical School, Bologna, Italy.
4
Section of Biomedical Statistics, Department of Cardio-Thoracic and Vascular Sciences, University of Padova Medical School, Padova, Italy.
5
Pediatric and Congenital Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padova, Italy.

Abstract

OBJECTIVES:

The aim of this multicentric study was to outline surgical indications and evaluate mid-term outcomes of porcine extracellular matrix (ECM) in surgery for congenital heart disease (CHD).

METHODS:

The use of ECM was categorized into four major groups: A, valve repair; B, septal reconstruction; C, arterial plasty; D, other use. Primary endpoints of analysis were reintervention (either surgical or interventional) when related to ECM, and functional ECM failure. Secondary endpoints were evidence of calcification and of persistent inflammation at follow-up.

RESULTS:

One hundred and three patients (M/F = 61/42, median age 19.7 months, 1 day-62 years) underwent surgical repair for CHD. Among ECM use categories, 38 patients were in Group A, 16 in Group B, 71 in Group C and 7 in Group D. There were neither complications nor deaths related to ECM. At a median follow-up of 23.3 months (0.3-55.2), 19 patients underwent reoperation (ECM-related in 6); 11 patients underwent interventional cardiology procedures (ECM-related in 8). Reinterventions were significantly more frequent on the aortic valve (surgical, P = 0.0056) and pulmonary arteries (interventional, P = 0.0159). In addition, interventional procedures on pulmonary arteries were significantly more frequent in infants <12 months (P = 0.0474). No calcifications were detected.

CONCLUSIONS:

Surgical use of ECM in CHD repair is characterized by a suboptimal functional late performance on reconstruction of valve leaflet or pulmonary artery wall. Longer follow-up and larger clinical experience may support these preliminary results on mid-term outcomes, so as to assess the optimal indication for an ECM graft.

KEYWORDS:

Congenital heart disease; Extracellular matrix; Outcomes; Scaffold; Small intestine submucosa; Surgery

PMID:
25888340
DOI:
10.1093/icvts/ivv076
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center