7284University of Washington, Seattle, WA, USA.
5228University of Wisconsin, Madison, WI, USA.
World J Pediatr Congenit Heart Surg. 2022 Jul;13(4):518-521. doi: 10.1177/21501351211069559. Epub 2022 Jan 5.
Pulmonary valve replacement (PVR) with right ventricular outflow tract (RVOT) reconstruction is a common congenital cardiac operation. Porcine submucosal intestinal-derived extracellular matrix (ECM) patches have been used for RVOT reconstruction. We present 2 adult patients with Tetralogy of Fallot who underwent PVR with RVOT reconstruction utilizing ECM. Both cases required reoperation due to patch dehiscence causing a large paravalvular leak. One patient also had a pseudoaneurysm associated with ECM dehiscence. There may be a propensity for ECM dehiscence in this application and, based on these cases, we recommend avoidance of ECM in RVOT reconstruction with PVR. PVR patients repaired with ECM should be monitored for this complication.
肺动脉瓣置换术（PVR）联合右心室流出道（RVOT）重建是一种常见的先天性心脏手术。猪黏膜下肠源性细胞外基质（ECM）补片已被用于 RVOT 重建。我们报告了 2 例接受 ECM 用于 RVOT 重建的法洛四联症患者的 PVR 手术。由于补片裂开导致大量瓣周漏，这 2 例均需再次手术。1 例患者还伴有 ECM 裂开相关的假性动脉瘤。在这种应用中，ECM 裂开的可能性较大，基于这 2 例病例，我们建议避免在 PVR 中使用 ECM 进行 RVOT 重建。接受 ECM 修复的 PVR 患者应注意监测这种并发症。
