Pavy Carine, Michielon Guido, Robertus Jan Lukas, Lacour-Gayet François, Ghez Olivier
Department of Cardiac Surgery, Royal Brompton Hospital, London, UK.
Department of Pathology, Royal Brompton Hospital, London, UK.
Interact Cardiovasc Thorac Surg. 2018 Mar 1;26(3):448-453. doi: 10.1093/icvts/ivx295.
We present the initial 2-year results of CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) implantation in paediatric patients with congenital heart diseases.
This was a single-centre retrospective study with prospectively collected data of all patients aged 18 years and under operated for congenital heart disease. The patch was introduced in 2014, with clinical practice committee approval and a special consent in case of an Ozaki procedure. Standard follow-up was performed with systematic clinical exams and echocardiograms. In case of reoperation or graft failure, the patch was removed and sent for a histological examination.
Between March 2014 and April 2016, 101 patients had surgical repair using a CardioCel patch. The mean age was 22 (±36.3) months, and the mean weight was 9.7 (±10.3) kg. No infections and no intraoperative implantation difficulties were associated with the patch. The median follow-up period was 212 (range 4-726) days. The overall 30-day postoperative mortality was 3.8% (n = 4), none of which were related to graft failure. Five children were reoperated because of graft failure, 4 of whom had the patch implanted for aortic and were aged less than 10 days. The indications for patch implantation in the aortic position were aortopulmonary window, truncus arteriosus, coarctation and aortic arch hypoplasia repair. The median time between the first and the second operation for graft failure was 245 (range 5-480) days.
Our experience shows that the patch is well tolerated in the septal, valvar and pulmonary artery positions. However, we experienced graft failures in infants in the aortic position.
我们展示了CardioCel®补片（澳大利亚西澳大利亚州珀斯市阿德默斯再生私人有限公司）植入先天性心脏病儿科患者的最初2年结果。
这是一项单中心回顾性研究，前瞻性收集了所有18岁及以下接受先天性心脏病手术患者的数据。该补片于2014年引入，经临床实践委员会批准，在进行大崎手术时需特别同意。通过系统的临床检查和超声心动图进行标准随访。如再次手术或移植物失败，取出补片并送去进行组织学检查。
2014年3月至2016年4月期间，101例患者使用CardioCel补片进行了手术修复。平均年龄为22（±36.3）个月，平均体重为9.7（±10.3）千克。补片未引发感染，术中植入也无困难。中位随访期为212（范围4 - 726）天。术后30天总体死亡率为3.8%（n = 4），均与移植物失败无关。5名儿童因移植物失败接受了再次手术，其中4名植入补片用于主动脉，年龄小于10天。主动脉位置补片植入的适应证为主肺动脉窗、动脉干、缩窄和主动脉弓发育不全修复。移植物失败的首次和第二次手术之间的中位时间为245（范围5 - 480）天。
我们的经验表明，该补片在间隔、瓣膜和肺动脉位置耐受性良好。然而，我们在主动脉位置的婴儿中遇到了移植物失败的情况。
