Hemashield implantation in young patients with congenital cardiovascular lesions.
BACKGROUND
There is substantial controversy regarding the use of Hemashield in young patients.


METHODS
Twenty-one consecutive patients younger than 20 years of age with a variety of congenital cardiovascular lesions underwent surgical procedures using a Hemashield woven graft. Hemashield was used for reconstruction of the aortic wall (n = 16), ventricular septum (n = 10), and right ventricular free wall or pulmonary artery (n = 6).


RESULTS
A sterile inflammatory reaction was observed including high fever, increased white cell count, and elevated plasma C-reactive protein concentration for up to 4 weeks after implantation. Multivariable analysis identified the use of Hemashield in the right ventricular free wall or pulmonary artery as an incremental risk factor for elevation of plasma C-reactive protein concentration during the first 3 weeks after implantation (p = 0.002). There were no midterm complications including restenosis of the grafts in the right ventricular outflow tract.


CONCLUSIONS
Hemashield can be used in a variety of situations for reconstruction of congenital cardiovascular lesions in young patients. Impregnated collagen can cause a significant systemic inflammatory reaction for several weeks after implantation, especially when used in the low-pressure right heart.
Aeba
R
R
Division of Cardiovascular Surgery, Keio University, Tokyo, Japan. aeba@mc.med.keio.ac.jp
Katogi
T
T
Kawada
S
S
D000293:Adolescent; D019917:Blood Vessel Prosthesis Implantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*