Decellularized Equine Pericardium in Congenital Heart Surgery: Midterm Results

Background: The aim of this study was to report midterm outcomes of decellularized equine pericardium when used for repair of congenital heart defects in children and young adults.

Method: A retrospective review was performed to identify all patients undergoing decellularized equine pericardium patch implantations at a single institution between 2016 and 2020. The patch performance was studied in respect to the specific anatomic implant location. Baseline/intraoperative characteristics, surgical feasibility, patch-related complications, mortality and reinterventions were analyzed.

Results: A total of 200 patients underwent 209 procedures, in which the patch was used for 314 locations/ implantation. The median age at implantation was 2.4 years (IQR: 0.7–6.3), with a third (34.4%) of the patients being infants. The patch was used in following numbers and locations: 173 for repair of pulmonary arteries, 36 for repair of septal defects, 26 for repair of the aorta, 21 for valvular repair and 58 at other locations. Main application was in redo surgeries (87.6%). At a median follow-up of 20.9 months (IQR: 9.2–32.9), 16 deaths (8%) occurred, none was patch-related. Overall 5-year survival rate was 91.5% (95% CI: 86.2–94.8). Early patch-related reoperations/catheter reinterventions occurred in 19 locations (6%). The patch was intact at time of discharge in 93.6% of locations, which were further followed. During follow-up, a total of 66 patch-related reoperations/catheter reinterventions occurred (22%). Overall freedom from patch-related reoperation and catheter reintervention per location, 12 and 24 months after initial surgery was 88.6% (95% CI: 83.9–92%) and 82.4% (95% CI: 76.4–87%) respectively. No patch-related complications occurred during the follow-up period.

Conclusion: Decellularized equine pericardium can be used for repair of a variety of congenital heart defects in children and young adults with good midterm durability. Reintervention rates are comparable to other reported xenogeneic materials used for similar implant locations.

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Artikel online veröffentlicht:
03. Februar 2022