Photo-oxidized bovine pericardium in congenital cardiac surgery: single-centre experience.
Dye-mediated photo-oxidation of pericardium is an alternative method to chemical treatment with glutaraldehyde for cross-linking collagen, providing biostability of the patch material while avoiding late calcification and cytotoxicity. There are few data available, on using photo-oxidation-treated pericardium, in congenital cardiac surgery. This study reports the outcomes using Photofix™ bovine pericardium in neonates, infants, children and young adults undergoing paediatric cardiac surgery.



A total of 490 patches in 383 consecutive operations (364 patients) were used in the surgical repair of congenital heart defects at our institution from October 2008 to October 2011. Recorded variables included demographic data, age at operation, primary cardiac diagnosis, associated complications and number, type and location of patches placed and patch-related reintervention.



Median age at operation was 5.3 years, ranging from <1 month to 56 years. The overall survival rate at late follow-up was 92%, and no deaths were related to failure of the tissue substitute. Two patients (0.5%) underwent reintervention late due to patch material failure: one for residual shunt after Rastelli repair and one for aneurysmal dilatation of a right ventricular outflow tract patch. The patch material was explanted in 8 patients at a mean of 20 months (range, 1-72 months) following implantation. Histological examination revealed mild to moderate inflammation with variable calcification.



Photo-oxidized bovine pericardium demonstrated excellent performance when used as a patch material in cardiovascular repair in children. Its handling characteristics and biocompatibility are consistent with a wide range of applications.
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Christopher W
CW
Baird
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.|Department of Cardiovascular Surgery, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Patrick O
PO
Myers
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Breanna
B
Piekarski
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Michele
M
Borisuk
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Amara
A
Majeed
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Sitaram M
SM
Emani
Cardiac Registry, Boston Children's Hospital, Boston, MA, USA.|Department of Cardiology, Boston Children's Hospital, Boston, MA, USA.|Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.|Department of Pathology, Boston Children's Hospital, Boston, MA, USA.|Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Stephen P
SP
Sanders
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Meena
M
Nathan
Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Pedro J
PJ
Del Nido
D000293:Adolescent; D000328:Adult; D000818:Animals; D002114:Calcinosis / Q000473:pathology; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005976:Glutaral; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D012189:Retrospective Studies; D015996:Survival Rate; D016378:Tissue Transplantation; D014183:Transplantation, Heterologous; D055815:Young Adult
D005976:Glutaral
Calcification; Congenital heart disease; Pericardial patch