McGrath L B, Gonzalez-Lavin L, Fernandez J
Department of Surgery, Deborah Heart and Lung Center, Browns Mills, NJ 08015.
ASAIO Trans. 1989 Oct-Dec;35(4):816-9.
Forty consecutive patients underwent intracardiac repair of acquired (15) and congenital (25) cardiac defects using a collagen sealed Dacron patch, baffle, or tube graft. Mean age at repair was 26.6 years (range, 1-74). Pediatric patients requiring valved extracardiac conduits were excluded from the study. Previous procedures had been done in 14 of the 40 patients (35%). There were three hospital deaths (7.5%), and two late deaths (5.4%), with an actuarial survival of 87 +/- 5.5% at 37 months after repair. Four patients required re-entry for bleeding (10%), but in no patient was bleeding related to leakage through the patch. There were no episodes of hemolysis. Mediastinitis occurred in one patient (2.7%) and resolved with usual treatment. There were no late reoperations, with actuarial freedom from reoperation 100% at 37 months after repair. The authors conclude that surgical implantation of collagen impregnated Dacron provides good early phase results. The collagen treated knitted Dacron has excellent handling characteristics and is impermeable. However, because of concerns regarding the potential for thick intimal peel formation due to variable collagen resorption rates, the authors continue to recommend pulmonary homografts when a valved extracardiac conduit is required in children.
40例连续患者使用胶原密封的涤纶补片、挡板或管状移植物进行了后天性（15例）和先天性（25例）心脏缺损的心脏内修复。修复时的平均年龄为26.6岁（范围1 - 74岁）。需要带瓣心外管道的儿科患者被排除在研究之外。40例患者中有14例（35%）曾接受过先前的手术。有3例医院死亡（7.5%），2例晚期死亡（5.4%），修复后37个月的精算生存率为87±5.5%。4例患者因出血需要再次手术（10%），但无一例出血与补片渗漏有关。没有溶血事件发生。1例患者发生纵隔炎（2.7%），经常规治疗后痊愈。没有晚期再次手术，修复后37个月再次手术的精算无再手术率为100%。作者得出结论，胶原浸渍涤纶的外科植入提供了良好的早期结果。经胶原处理的针织涤纶具有优异的操作特性且不透水。然而，由于担心胶原吸收速率变化可能导致内膜厚皮形成，作者继续建议在儿童需要带瓣心外管道时使用肺同种异体移植物。
