Tissue engineering bovine pericardium patch in repair of heart defects

doi:10.3969/j.issn.2095-4344.2013.18.011

Abstract

Abstract:

BACKGROUND: Terylene mesh has been routinely used for cardiac surgery because of its thin texture, light weight and good biocompatibility, but in recent years, we have found that ventricular septal defect repaired with terylene mesh can cause postoperative residual leakage which is prone to cause hemolysis, bacterial or fungal infection.
OBJECTIVE: To explore the effect of bovine pericardium patch in repairing of congenital heart septal defect.
METHODS: A total of 152 cases of heart septal defects were treated with glutaraldehyde-fixed bovine pericardium patch, including 56 cases of atrial septal defect, 78 cases of ventricular septal defect, 18 cases of partialatrioventricular septal defect., The early illness status, hemodynamic and cardiac functions were observed by re-examining electrocardiogram, chest radiography, cardiac ultrasound and laboratory examination after surgery.
RESULTS AND CONCLUSION: All the 152 cases received the repair surgery without postoperative death, and the patients were followed-up for 2-6 months. No bleeding, hemolysis, thrombus, infection or rejection were observed when using the bovine pericardium patch and at early postoperative period. There was only one patient with pulmonary hypertension caused hypertensive crisis on the first postoperative day and recovered after the emergency treatment. Re-examining electrocardiogram, chest radiography and cardiac ultrasound showed the heart septal defects were repaired completely without residual shunt, the pulmonary artery pressure was decreased significantly, the valve was closed without shunt, the cardiac function was in the normal level. The results indicate that bovine pericardium patch can repair heart septal defects effectively, improve the hemodynamics and cardiac function with satisfactory short-term effect, it is a favorable material used for repairing the heart septal defects.

Key words: organ transplantation, clinical practice in organ transplantation, bovine pericardium patch, heart septal defects, repair, atrial septal defect, ventricular septal defect, atrioventricular septal defect

CLC Number:

R318

Li Bo, Wang Hui-shan, Fang Min-hua, Hang Hong-guang, Wang Zhen-long, Li Xiao-mi. Tissue engineering bovine pericardium patch in repair of heart defects[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(18): 3303-3310.

Figures/Tables 2

2.1 参与者数量分析 152例患者均完成修补手术，术后无早期死亡，患者随访2-6个月，全部进入结果分析。 2.2 间隔缺损修复的结果症状：患者一般状态良好，无发热、咳嗽等症状，饮食睡眠可，尿便正常，口唇无发绀，无活动后心慌气短，无胸闷胸痛等症状。查体：听诊双肺呼吸音清，未闻及干湿性罗音，心律齐，心脏各瓣膜听诊区未闻及明显杂音。患者四肢温暖，眼睑及双下肢无水肿。切口愈合良好，无红肿、渗出。超声心动图示：心脏间隔缺损修复完全，无残余分流；肺动脉压力明显下降；室缺补片活瓣已关闭无分流；心脏功能正常；无动脉导管及其开口撕裂或出血，动脉导管封闭满意。心电图检查：窦性心动过速、房颤心律、窦性心律均消失，心律齐，窦性心律。完全性或不完全性右束支传导阻滞3例消失。 X射线胸部平片：心胸比率0.51±0.02，肺血不同程度减少，纹理清晰。并发症：152例牛心包片在使用过程中及术后早期均未发现漏血、溶血、血栓、感染、排斥反应等并发症。术后无早期死亡。1例患者因合并肺动脉高压，术后第1天出现高血压危象，经过抢救后好转。 2.3 材料宿主反应经过2-16个月的随访，未发现牛心包片撕裂、血栓、明显钙化、瘤样膨出、排斥反应、后期感染等不良反应，效果良好。 2.4 典型病例病例1：继发孔房间隔缺损。患者女性，44岁，因“发现心脏杂音43年，活动后胸闷、心悸4年，加重2年”于2011年10月7日收治入院。查体：神志清楚，口唇无发绀，听诊双肺呼吸音清，未闻及干湿啰音，心率86次/min，心律规整，胸骨左缘第2、3肋间可闻及3/6级收缩期喷射性杂音，肺动脉瓣区第二音增强，腹平软，肝脾肋下未及，四肢末梢温暖，双下肢无浮肿。本院门诊超声心动图检查：先天性心脏病，非紫绀型，房间隔回声中断18 mm，三尖瓣关闭不全，估测肺动脉压61 mm Hg(1 mm Hg=0.133 kPa)。于2011年10月11日在全麻体外循环下行房间隔缺损心内补片修补、三尖瓣成形术，术后恢复顺利，治愈出院。房间隔缺损心内补片修补前后超声心动图图片见图1，2。"

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