Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Ann Thorac Surg. 2018 Oct;106(4):1241-1244. doi: 10.1016/j.athoracsur.2018.04.086. Epub 2018 Jun 7.
The objective of this study was to assess the performance of a tissue engineering process-treated bovine pericardium patch (CardioCel, Admedus Regen Pty Ltd, Perth, Australia) in the setting of reconstructive mitral valve surgical procedures.
Between March 2014 and April 2016, 30 patients (57.2 ± 14.3 years of age; 27% female) underwent mitral valve leaflet repair with a CardioCel patch.
Perioperative mortality was 7% (2 patients, non-graft related). In the 28 remaining patients, predischarge echocardiography demonstrated good repaired valve function. At a mean follow-up of 1.7 ± 0.9 years, three additional deaths occurred (two resulting from infective endocarditis and one non-cardiac related). On follow-up echocardiography (follow-up time of 1.7 ± 0.8 years; available for 26 of 28 [93%] hospital survivors), recurrent regurgitation was seen in 2 patients (both with infective endocarditis), and 1 patient underwent reoperation (no infection at the level of patch repair was observed). In the remaining patients, the most recent echocardiogram demonstrated no regurgitation or mild regurgitation and stable gradients. The thickness and echodensity of the implanted patch on follow-up echocardiograms were comparable with postoperative echocardiograms.
Initial results with the CardioCel patch in mitral valve repair operations were satisfactory. The resistance to infection and late degeneration will need to be assessed in the future.
本研究旨在评估经组织工程处理的牛心包补片(CardioCel,Admedus Regen Pty Ltd,珀斯,澳大利亚)在重建二尖瓣手术中的性能。
2014 年 3 月至 2016 年 4 月,30 例患者(57.2±14.3 岁;27%为女性)接受了 CardioCel 补片二尖瓣瓣叶修复。
围手术期死亡率为 7%(2 例,与移植物无关)。在其余 28 例患者中,出院前超声心动图显示瓣膜功能良好。在平均 1.7±0.9 年的随访中,又有 3 例死亡(2 例死于感染性心内膜炎,1 例与心脏无关)。在随访超声心动图(随访时间 1.7±0.8 年;28 例住院幸存者中有 26 例[93%]可获得)中,2 例患者(均为感染性心内膜炎)出现复发性反流,1 例患者再次手术(补片修复水平未观察到感染)。在其余患者中,最近的超声心动图显示无反流或轻度反流和稳定的梯度。植入补片的厚度和回声密度在随访超声心动图上与术后超声心动图相似。
CardioCel 补片在二尖瓣修复手术中的初步结果令人满意。未来需要评估其抗感染和晚期退化的能力。