Abu Saleh Walid K, Al Jabbari Odeaa, Ramlawi Basel, Bruckner Brian A, Loebe Matthias, Reardon Michael J
Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.
Valley Health System, Winchester, Virginia.
Methodist Debakey Cardiovasc J. 2016 Apr-Jun;12(2):116-8. doi: 10.14797/mdcj-12-2-116.
Primary cardiac sarcomas are rare and carry a grave prognosis. Improved survival requires a complete margin negative resection of the tumor. These surgical resections are often large and complex, requiring extensive reconstructive procedures. The appropriate material for cardiac reconstruction is not known. We have used glutaraldehyde-fixed bovine pericardium in our early series but have recently employed the MatriStem(®) Surgical Matrix PSMX membrane (ACell(®), Inc.; Columbia, MD), a unique proprietary urinary bladder matrix derived from porcine urinary bladder with the potential for viability and tissue ingrowth. In our study of six patients at this institution, all six underwent successful surgical resection and repair with the MatriStem acellular porcine urinary bladder membrane (ACell). The postoperative course was uncomplicated in all patients, and they are still alive at this time. An aggressive surgical approach to cardiac tumors can possibly lead to complete resection but often requires reconstruction of the cardiac tissue with a membrane. We were able to achieve acceptable results in our cardiac reconstruction by using the ACell extracellular matrix to reconstruct the defect following tumor resection. Longer-term follow-up in these patients, including imaging studies, will be necessary to demonstrate the durability and integrity of the reconstruction.
原发性心脏肉瘤较为罕见,预后严重。提高生存率需要对肿瘤进行完整的切缘阴性切除。这些手术切除通常范围大且复杂,需要广泛的重建手术。目前尚不清楚用于心脏重建的合适材料。在我们早期的系列研究中,我们使用了戊二醛固定的牛心包,但最近采用了MatriStem®手术基质PSMX膜(ACell®公司;马里兰州哥伦比亚),这是一种独特的专有膀胱基质,源自猪膀胱,具有存活和组织向内生长的潜力。在我们对本机构6例患者的研究中,所有6例患者均使用MatriStem脱细胞猪膀胱膜(ACell)成功进行了手术切除和修复。所有患者术后过程均无并发症,目前均存活。积极的心脏肿瘤手术方法可能导致完整切除,但通常需要用膜重建心脏组织。通过使用ACell细胞外基质在肿瘤切除后重建缺损,我们在心脏重建中取得了可接受的结果。对这些患者进行长期随访,包括影像学研究,对于证明重建的耐久性和完整性是必要的。