Pediatric Cardiology

, Volume 38, Issue 7, pp 1337–1341 | Cite as

Efficacy of an Extracellular Matrix in Systemic Loading Conditions in Congenital Heart Surgery

  • Adeel Ashfaq
  • Amit Iyengar
  • Oh Jin Kwon
  • Mohammad S. Soroya
  • Son Nguyen
  • Ryan Ou
  • Brian Reemtsen
Original Article
  • 99 Downloads

Abstract

Extracellular matrices (ECM) are commonly used to repair congenital heart defects; however, there is a lack of literature pertaining to outcomes with ECM use in high-pressure conditions. Between 2011 and 2014, a total of 202 patients underwent congenital heart disease repair using the ECM placed in a systemic pressure condition. The operative sites included: defects in the ventricular septum, mitral valve, aortic valve, ascending aorta, and aortic arch. Patients were followed and evaluated for mortality and reoperations due to loss of ECM integrity. Echocardiograms were evaluated for graft malfunction such as aneurysmal dilation, VSD formation, valve malfunction, or outflow tract obstruction. Patients were followed for an average of 1492 days (Median = 1583). Out of the 202 patients, 7 (3.5%) died due to complications unrelated to ECM, and 10 (5%) underwent reoperations due to complications of ECM integrity. Reoperations were as follows: two of 6 patients receiving aortic leaflet replacement required reoperation for leaflet failure; four of 12 patients receiving mitral valve leaflet repairs required reoperation for leaflet failure; and four of 142 patients with VSD repair required reoperation for residual shunting. The average time to reoperation was 208 days. There were no outflow tract obstructions or aneurysmal dilatations observed. This modern case series suggests that the ECM is efficacious and sustainable under systemic conditions in congenital heart defect repair. However, concerns remain about the use of ECM in aortic valve repair and infant mitral valve repair. Further studies are needed to evaluate long-term ECM integrity.

Keywords

Systemic to pulmonary shunt Shunt failure Shunt thrombosis 

Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Institutional Review Board at UCLA. The study design was a retrospective chart review of patients, and thus, there were no interventions, or involvement with human or animal subjects. This article does not contain any studies with animals or humans performed by any of the authors.

Informed Consent

This was a retrospective chart review, and thus, no informed consent was needed in this study.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Adeel Ashfaq
    • 1
  • Amit Iyengar
    • 1
  • Oh Jin Kwon
    • 1
  • Mohammad S. Soroya
    • 1
  • Son Nguyen
    • 1
  • Ryan Ou
    • 1
  • Brian Reemtsen
    • 2
    • 3
  1. 1.David Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.Mattel Children’s HospitalLos AngelesUSA
  3. 3.UCLA Cardiothoracic SurgeryLos AngelesUSA

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