Bovine pericardium patch repairs heart defects and aerosolized iloprost reduces pulmonary hypertension

doi:10.3969/j.issn.2095-4344.2014.25.016

Abstract

Abstract:

BACKGROUND: The treatment of pulmonary hypertension secondary to congenital heart disease has been a hot topic in the clinical research on cardiac surgery. Although traditional drugs for reducing pulmonary hypertension have excellent effects, there are some defaults, such as difficult monitoring and rebounding phenomenon after drug withdrawal. The traditional heart dacron graft is prone to cause complications, such as deformation, thrombosis, embolism, hemolysis and infection.
OBJECTIVE: To investigate the effect of glutaraldehyde-fixed bovine pericardium patch and aerosolized iloprost in patients with pulmonary hypertension secondary to congenital heart disease.
METHODS: Ninety patients with pulmonary hypertension due to congenital heart disease underwent a surgery. Glutaraldehyde-treated bovine pericardium patch were used to repair cardiac septal defect, and then aerosolized iloprost was applied after operation, administered for 3 days according to 30 ng/min/kg, every 4 hours in the first 12 hours of a day, and every 6 hours in the resting 12 hours. Mean arterial pressure, mean pulmonary arterial pressure, systemic vascular resistance index, pulmonary vascular resistance index were recorded before inhalation, immediately after inhalation, and 30 minutes after inhalation. The pericardium-associated complications, and cardiac function were also observed at follow-ups.
RESULTS AND CONCLUSION: The involved 90 cases were detected by echocardiography. The results showed that, all the flaps were closed, there was no shunting or echo discontinuation of atrial septum. The heart contraction function was normal. No pericardium-associated complications were found. There was no significant difference in the mean arterial pressure and systemic vascular resistance index in all patients at different time points. The mean pulmonary arterial pressure and pulmonary vascular resistance index immediately after inhalation were significantly lower than that before inhalation (P < 0.01). The decrease was also significant 30 minutes after inhalation (P < 0.05). The intervention of glutaraldehyde-fixed bovine pericardium patch and aerosolized iloprost is safe and effective to treat patients with pulmonary hypertension secondary to congenital heart disease.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: pericardium, hypertension, pulmonary, heart diseases

CLC Number:

R318

Han Hong-guang, Han Jin-song, Wang Hui-shan, Fang Min-hua, Li Bo, Li Xiao-mi, Xu Li-ying,Meng Qing-tao. Bovine pericardium patch repairs heart defects and aerosolized iloprost reduces pulmonary hypertension[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(25): 4026-4031.

Figures/Tables 2

References

[1] 刘锦纷.先天性心脏病外科综合治疗学[M].北京:北京大学医学出版社,2009:29.
[2] 李晓密,韩宏光,李新民,等.膨体聚四氟乙烯片作单瓣重建右室流出道术后早期并发症及处理[J].麻醉与监护论坛, 2013,20(1): 45-47.
[3] 王明刚,孙文兵,杨硕,等.聚丙烯复合脱细胞基质的新型复合补片耐受感染能力的实验研究[J].首都医科大学学报,2013,34(2): 282-286.
[4] Braga-Vilela AS,de Campos Vidal B.Identification of elastic fibers and lamellae in porcine pericardium and aorta by confocal, fluorescence and polarized light microscopy.Acta Histochem.2006;108(2):125-132.
[5] 孙浩峰,梁家立,姜冠华.带单瓣牛心包补片在先心病重度肺动脉高压治疗中的应用[J].中国医师杂志,2009,11(3):357-358.
[6] Crawford FA,Sede RM,Spinale F.Bovine pericardium for correction of congenital heart defects.Ann Thorac Surg. 2006; 41(6):602-605.
[7] Nishimura M,Yamagishi M,Fujiwara K,et al.Incomplete atrioventricular septal defect with hypoplastic left ventricle and left atrioventricular valve stenesis. Jpn J Thorac Cardiovase Surg.2005;49(4):247-249.
[8] 孙浩峰,梁家立,郑晓舟,等.带单瓣牛心包补片在法洛四联征疏通右室流出道中的应用研究[J].实用心脑肺血管病杂志, 2011, 19(4):604.
[9] 钟齐庆,杜正隆,凌毅.带瓣牛心包补片在法洛四联症治疗中的研究[J].齐齐哈尔医学院学报,2013,34(11):1609-1610.
[10] 杨岷,成少飞,王学宁,等.牛心包组织工程心脏瓣膜支架脱细胞的研究[J].上海交通大学学报:医学版,2006,26(1):72-75.
[11] Badylak SF.Xenogeneic extracellularmatrix as a scaffold for tissue reconstruction.Trenspl Immunol.2004;12(3):367-377.
[12] Galie N,Torbieki A,Barst R,et al.Guidelines on diagnosis and treatment of pulmonary arterial hypertension．The task force on diagnosis and treatment of pulmonary arterial hypertension of the european society of cardiology．Eur Heart J.2004;25(24):2243-2278.
[13] 孙浩峰,梁家立,郑晓舟,等.带单瓣牛心包补片在法洛四联征疏通右室流出道中的应用研究[J].实用医药杂志,2011,28(4):500.
[14] 周朝元.室间隔缺损的外科治疗[J].中国社区医师:医学专业, 2011,13(1):28-29.
[15] 吴向阳,朱洁,黄维勤,等.连续缝合法修补膜周部大室间隔缺损[J].心肺血管病杂志,2009,27(4):226-228.
[16] 孙浩峰,梁家立.牛心包在心脏外科中的应用[J].实用心脑肺血管病杂志,2010,18(9):1314-1316.
[17] 杨岷,成少飞,王学宁,等.牛心包组织工程心脏瓣膜支架脱细胞的研究[J].上海交通大学学报:医学版,2006,48(1):72-75.
[18] Schoen FJ,Levy RJ.Calcification of tissue heart valve substitutes:progress toward understanding and prevention. Ann Thorac Surg.2005;79(3):1072-1080.
[19] 彭勇,郭应强,张尔永.牛心包生物瓣膜的临床应用[J].中国胸心血管外科临床杂志,2007,14(2):144-146.
[20] 高波涛,郑景浩,刘玉洁,等.自体心包补片在婴幼儿简单室间隔缺损修补中的应用[J].上海交通大学学报,2011,31(9):1352-1354.
[21] 夏打萍,黄国英.一氧化氮吸入撤离后反跳性肺高压研究进展[J].国外医学:儿科学分册,2004,31(3):143-145.
[22] 魏昕,李娟,王瑞婷,等.米力农复合一氧化氮对先天性心脏病患者体外循环后肺动脉高压的影响[J].中华麻醉学杂志,2007,27(10): 869-872.
[23] 陈仁伟,周文武,罗金文,等.西地那非治疗婴幼儿先天性心脏病术后肺动脉高压[J].医学临床研究,2011,28(8):1444-1446.
[24] Oishi P,Grobe A,Benavidez E,et al.Inhaled nitric oxide induced NOS inhibition and rebound pulmonary hypertension: a role for superoxide and peroxynitrite in the intact lamb.Am J Physiol Lung Cell Mol Physiol.2006;290(2):L359-366.
[25] Shekerdemian LS,Ravn HB,Penny DJ.Intravenous sildenafil lowers pulmonary vascular resistance in a model of neonatal pulmonary hypertension. Am J Respir Crit Care Med. 2002; 165(8):1098-1102.
[26] 曾嵘,庄建.枸橼酸西地那非治疗心脏手术后肺动脉高压的临床研究[J].中华心血管病杂志,2005,33(10):916-919.
[27] Rubin LJ.Pulmonary arterial hypertension.PATS. 2006;3(1): 111-115.
[28] Hoeper MM,Rubin LJ.Update in pulmonary hypertension 2005.Am J Respir Crit Care Med.2006;173(5):499-505.
[29] Hsu HH,Rubin LJ.Iloprost inhalation solution for the treatment of pulmonary arterial hypertension.Exp Opinn Pharmaeoth. 2005;6(11):1921-1930.
[30] Langer F,Wilhelm W,Tscholl D,et al.Intraoperative inhalation of the long-acting prostacyclin analog iloprost for pulmonary hypertension.J Thorac Cardiovasc Surg. 2003;126(3): 874-875.