Tissue-engineered bovine pericardium patch in staged repair of Tetralogy of Fallot

doi:10.3969/j.issn.2095-4344.2013.12.016

Abstract

Abstract:

BACKGROUND: A perfect repairing material is necessary to improve the quality of life in staged repair of Tetralogy of Fallot to enlarge the right ventricular outflow tract that is serious narrow. The materials currently used for outflow tract widening include biological patch and man-made fabric patch.
OBJECTIVE: To compare the effects of tissue-engineered bovine pericardium patch and Dacron patch in staged repair of Tetralogy of Fallot to widen the right ventricular outflow tract.
METHODS: Twenty-five patients with Tetralogy of Fallot who had undergone the first-stage shunt operation were divided into two groups according to the date of second stage surgery. Polyester-made artificial blood vessel patch group included 14 cases, and the right ventricular outflow tract was enlarged with polyester-made artificial blood vessel patches (from April 2007 to July 2010); tissue engineered bovine pericardium patch group included 11 cases, and the right ventricular outflow tract was enlarged with bovine pericardium patches (from August 2010 to September 2011). Clinical effects of the two groups in the early stage postoperation were compared.
RESULTS AND CONCLUSION: There was one case of postoperative death in the polyester-made artificial blood vessel patch group. Ventilator time, the ratio of right ventricular pressure and left ventricular pressure, the pressure gradient across the right ventricular outflow tract, the pericardial cavity drainage volume, ICU time and length of hospital stay in the bovine pericardium patch group were less than those in the polyester-made artificial blood vessel patch group (P < 0. 05) . Tissue engineered bovine pericardium patch can be adapted as a better repairing material in staged repair of Tetralogy of Fallot to enlarge the right ventricular outflow tract.

Key words: biomaterials, biomaterial clinical practice, Tetralogy of Fallo, tissue-engineered bovine pericardium, right ventricular outflow tract, polyester-made artificial blood vessel patch, second-stage intracardiac correction, complications

CLC Number:

R318

Li Bo, Wang Hui-shan, Wang Zeng-wei, Fang Min-hua, Han Hong-guang, Wang Zhen-long. Tissue-engineered bovine pericardium patch in staged repair of Tetralogy of Fallot[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(12): 2197-2204.

Figures/Tables 5

References

[1] Sun HF, Liang JL, Zheng XZ.Shiyong Yixue Zazhi.2011;28(6): 500. 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(6):500.

[2] Liu Z,Wu HX,Cheng J.Guangdong Yixue.2012;34 (6): 803-804. 刘正,武何晓,陈进.心脏涤纶补片在髁突骨折治疗中的应用体会[J].广西医学,2012,34 (6):803-804.

[3] Wang HQ,Mao AF.Huli Shijian Yu Yanjiu.2009;6(19):57-59. 王宏琴,茅爱芳.小儿重症法洛四联症二期根治术的术后监护[J].护理实践与研究,2009,6(19):57-59.

[4] Qu JZ.Congenital heart diseases with right-to-left shunts. Int An esthesiol Clin.2004;42(4): 59-72.

[5] Starr JP. Tetralogy of fallot: yesterday and today. World J Surg.2010;34(4) : 658-668.

[6] Castaneda AR. Classical repair of tetralogy of Fallot : timing, technique and results. Semin Thorac Cardiovasc Surg.1990; 2(1): 70-75.

[7] Marshall AC, Love BA, Jonas RA,et al. Staged repair of tetralogy of Fallot and diminutive pulmonary arteries with a fenestrated ventrcular septal defect patch . J Thorac Cardiovasc Surg.2003;126(5):1427-1433

[8] Blackstone EH, Kirklin JW, Bertranou EG, et al. Preoperative predicti on from cineangiograms of postrepair right ventricular pressure in tetralogy of Fallot. J Thorac Cardiov Surg.1979; 78(4):542-552.

[9] Chen CC,Shen ZL.Zhongguo Xiongxinxueguan Waike Linchuang Zazhi.1999;6(2): 120-121. 陈长春,沈宗林.自体心包和其它修补材料在心脏手术中的应用[J]..中国胸心血管外科临床杂志,1999,6(2): 120-121.

[10] Carrel T. Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract . Expert Rev Med Devices. 2004;1(1):11-19.

[11] Pan Z.Xinxueguan Waike Jinzhan.1983: 99-115. 潘治,主编.心血管外科进展[M].北京:人民卫生出版社,1983: 99-115.

[12] Sun HF, Liang JL.Shiyong Xinnao Feixueguan Zazhi.2010; 18(9):1314-1316. 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.

[13] Zhang BG,Chen XF.Wuhan Yixueyuan Xuebao.1982;3:15-19. 张本固,陈夏丰.牛心包管作为动脉代用品的实验研究[J].武汉医学院学报,1982,3:15-19.

[14] Tang LS,Nie AG,Tang JL,et al.Zhongguo Shiyong Yanke Zazhi.1994;12 (12): 759-760. 唐罗生,聂爱光,谭家铃,等.用牛心包行额肌悬吊术[J].中国实用眼科杂志,1994,12 (12): 759-760.

[15] Hu JY,Yao X,Zhao GL.Baotou Yixueyuan Xuebao.1997; 13(2):32-33. 胡景元,姚喜,赵根连.牛心包修补硬脑膜缺损的临床应用研究[J].包头医学院学报,1997,13(2):32-33.

[16] Wang Y,Xu YD,Li JS.Zhonghua Waike Zazhi.1994;32(5): 269-270. 王宇,许元弟,李建设.用牛心包行肝外胆道成形术[J].中华外科杂志,1994,32(5):269-270.

[17] Ma J, He JL.Shandong Daxue Erbihou Xuebao.2011; 25(6): 92-93. 马敬,何君玲.牛心包补片在喉部分切除术组织缺损修复中的应用[J].山东大学耳鼻喉学报,2011,25(6):92-93.

[18] Zheng ZZ,Ding XL,He ZY,et al.Zhongguo Shiyong Yanke Zazhi.1994;12 (8): 463. 甄兆忠,丁小玲,何志远,等。牛心包在眼科整形中应用[J].中国实用眼科杂志,1994,12(8):463.

[19] Zhang YH,Lv WC,Tang ZW.Linchuang Miniao Waike Zazhi. 1994;9(1):12-43. 张玉海,吕文成,唐稚望.牛心包在泌尿外科的实验研究与临床应用[J].临床泌尿外科杂志,1994,9(1):12-43.

[20] Fu QC,Zheng CG,Cen XH,et al.Guangxi Yixueyuan Xuebao. 1987;4:15-16. 傅乾昌,郑陈光,岑晓华,等.应用牛心包补片治疗责门失弛缓症[J].广西医学院学报,1987,4:15-16.

[21] Wang Y,Xu YD,Tang ZC.Zhonghua Waike Zazhi.1994;32(3): 139. 王宇,许元弟,汤兆成.牛心包修补腹壁缺损及腹股沟疝71例临床报告[J].中华外科杂志,1994,32(3):139.

[22] Peng Y,GuoYQ,Zhang EY.Zhongguo Xiongxinguan Waike Linchuang Zazhi.2007;14(2):144-146. 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.

[23] Aravind S, Paul W, Vasudev SC, et al.Polyethylene glycol (PEG) modified bovine pericardium as a biomaterial: a comparative study on immunogenicity.J Biomater Appl. 1998; 13(2):158-165..

[24] Liu YG,Wang J,Yang F,et al.Zhonghua Xiongxinguan Waike Linchuang Zazhi.2003;19(5):310-311. 刘彦国,王俊,杨帆,等.国产牛心包垫片在肺减容手术中的临床应用[J].中华胸心血管外科杂志,2003, 19 (5):310-311.

[25] Wu RB, Luo ZX,Zhang JF,et al.Zhonghua Waike Zazhi.1996; 34(8):492-494. 吴若彬,罗征祥,张镜方,等.牛心包补片在法乐四联症矫治术中的应用[J].中华外科杂志,1996,34(8):492-494.

[26] Ding WX,Su ZK,Xu ZW.Zhonghua Xiongxinguan Waike Linchuang Zazhi.1995;11(1):30-31. 丁文祥,苏肇伉,徐志伟.国产微孔聚四氟乙烯心脏补片的实验观察与临床应用[J].中华胸心血管外科杂志,1995,1(1):30-31．

[27] Liu FY,Xu JY,Du JJ, et al.Shandong Yiyao.1997;37(1):41. 刘凡英,徐教瑜, 杜贾军, 等.涤纶牛心包衬片修补气管缺损3例报告[J].山东医药,1997,37(1):41.

[28] Li B, Di JZ,Jia ZY, et al.Zhongguo Quanke Yixue. 2009;12(2A): 238-239. 李波,狄建忠,贾震易, 等.国产涤纶补片在腹股沟疝无张力修补术中的效果观察[J].中国全科医学,2009,12(2A):238-239.

[29] Liu FX,Liu DC, Liu Y, et al.Yanwaishang Zhiye Yanbing Zazhi. 2006;28(5):376-378. 刘凤霞,刘德成, 刘懿, 等.心脏涤纶补片在义眼台置换术中的应用[J].眼外伤职业眼病杂志,2006,28(5):376-378.

[30] Lei JC,Liu DC.Yiyao Luntan Zazhi. 2010;31(12):75-76. 雷继承,刘德成.心脏涤纶补片在眼胎植换术中的临床应用[J].医药论坛杂志,2010,31(12):75-76.

[31] Zheng HS,Liu DW,Yang XQ, et al.. Yanwaishang Zhiye Yanbing Zazhi. 2004;26(8): 538-539. 郑寒松,刘德成,杨西强, 等.心脏涤纶补片在结膜瓣全角膜掩盖中的应用[J].眼外伤职业眼病杂志,2004,26(8): 538-539.

[32] Guo JQ,Guo JH, Wu XJ, et al..Zhongguo Xunhuan Zazhi. 1990;5(4): 279-282. 郭加强, 郭建华, 吴学军,等.法乐氏四联症根治术右室流出道，建标准的进一步探讨[J].中国循环杂志,1990,5(4): 279-282.

[33] Chittithavorn V, Rergkliang C, Chetpaophan A,et al.Predicted outcome after repair of tetralogy of Fallot by postoperative pressure ratio between right and left ventricle.J Med Assoc Thai. 2006;89(1):43-50.