用作心血管补片的牛心包。

Bovine pericardium used as a cardiovascular patch.

作者信息

Pires A C, Saporito W F, Cardoso S H, Ramaciotti O

机构信息

Paulista Medical School, São Paulo Federal University and ABC Medical School, São Paulo, SP, Brazil.

出版信息

Heart Surg Forum. 1999;2(1):60-9.

PMID:11276462

Abstract

BACKGROUND

The use of glutaraldehyde preserved bovine pericardium in valvular prostheses is well known. Although widely used clinically as patch material, bovine pericardium has not been extensively studied in this setting.

METHODS

With this objective, 21 dogs received a standard bovine pericardial patch to partially replace the aortic, left atrial, or pericardial walls. The dogs were randomly divided into three groups according to implant duration. Group 1 consisted of 6 dogs evaluated surgically after 33 to 43 postoperative days, Group 2 with 7 dogs reoperated after 120 to 165 days, and Group 3 with 8 dogs reoperated after 225 to 305 days.

RESULTS

Microscopic and macroscopic evaluation demonstrated: 1) the wrinkled surface of the bovine pericardium adhered to neighboring structures whereas the smooth surface did not adhere to the epicardium; 2) the bovine pericardial patch did not show structural changes in any of the implant sites; 3) the final left atrial patch was significantly smaller than the aortic and pericardial patches for Group 2 and Group 3 dogs; 4) the atrial patch area decreased significantly, whereas the aortic and pericardial areas did not change over time; 5) the pericardial implant was significantly thinner than the aortic and left atrial patches for Group 3 dogs; 6) a layer of fibrous connective tissue was formed on the smooth surface of the left atrial and aortic patches. The internal apposition fibrasis was significantly thicker in the left atrium than in the aorta in Groups 1 and 2; 7) the internal fibrasis layer of the atrial and aortic patches was calcified in Groups 2 and 3; and 8) the internal apposition tissue of the atrial and aortic patches showed neoformation of elastic fibers which clearly increased with implant duration.

CONCLUSIONS

The fate of implanted glutaraldehyde-preserved bovine pericardial patches in cardiovascular applications depends on three factors: 1) the contact surface, 2) the tension it is subjected to, and 3) contact with blood flow.

摘要

背景

戊二醛保存的牛心包用于心脏瓣膜假体已广为人知。尽管牛心包作为补片材料在临床上广泛应用，但其在这种情况下尚未得到广泛研究。

方法

为此，21只犬接受标准牛心包补片以部分替代主动脉、左心房或心包壁。根据植入持续时间将犬随机分为三组。第1组由6只犬组成，在术后33至43天进行手术评估；第2组有7只犬在120至165天后再次手术；第3组有8只犬在225至305天后再次手术。

结果

微观和宏观评估显示：1）牛心包的皱襞表面与相邻结构粘连，而光滑表面不与心外膜粘连；2）牛心包补片在任何植入部位均未显示结构变化；3）对于第2组和第3组犬，最终的左心房补片明显小于主动脉和心包补片；4）心房补片面积显著减小，而主动脉和心包补片面积随时间未发生变化；5）对于第3组犬，心包植入物明显比主动脉和左心房补片薄；6）在左心房和主动脉补片的光滑表面形成了一层纤维结缔组织。第1组和第2组中，左心房内的内贴附纤维组织明显比主动脉中的厚；7）第2组和第3组中，心房和主动脉补片的内纤维层发生钙化；8）心房和主动脉补片的内贴附组织显示弹性纤维新生，且随植入持续时间明显增加。