Thorac Cardiovasc Surg 2015; 63 - OP158
DOI: 10.1055/s-0035-1544410

First Experience of a Novel Decellularized Patch Material (CardioCel™) for Different Applications in Congenital Heart Surgery

S. Nordmeyer 1, M.-Y. Cho 2, J. Nordmeyer 1, S. Ovroutski 1, O. Miera 1, M. Musci 2, F. Berger 1, J. Photiadis 2
  • 1Klinik für Angeborene Herzfehler / Kinderkardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany
  • 2Klinik für die Chirurgie Angeborener Herzfehler und Kinderherzchirurgie, Deutsches Herzzentrum Berlin, Berlin, Germany

Objectives: The search for optimal patch material is an ongoing challenge in congenital heart surgery (CHS). In this study, we report our first experience with the use of a novel decellularized bovine pericardial patch material (CardioCel™) for different applications in CHS.

Methods: Retrospective review of our institutional experience with CardioCel™. Patient diagnoses ranged from valve lesions (e.g., bicuspid aortic valves, Ebstein anomaly, common AV-valve), septal defects (e.g., VSD), conotruncal lesions (e.g., tetralogy of fallot, TGA) and univentricular hearts (e.g., hypoplastic left heart syndrome). Operative details and early postoperative outcome parameters were used to identify graft-related morbidity. Echocardiographic results at discharge were used for the assessment of graft appearance and performance. Data are presented as median values (range).

Results: Between February 2014 and August 2014, CardioCel™ patch material was used during CHS in 37 patients with a median age of 6,1 years (6 days–49,7 years) and a median weight of 18 kg (3,2 - 111,6). Patch material was used for valve reconstruction in 21 patients (aortic, n = 13; pulmonary, n = 1; mitral, n = 2; tricuspid, n = 5), for closure of septal defects in 5 patients (atrial, n = 2; ventricular, n = 3), for patch enlargement of great arteries in 18 patients (aorta, n = 4; pulmonary, n = 14) and for creation of venous anastomoses in 2 patients (Glenn-anastomosis, n = 1; atrial switch with Senning-technique, n = 1). There were no intraoperative difficulties implanting the patch material. Cross-clamp time was 102 minute (44 - 345), perfusion time 168 minute (80 - 605) and reperfusion time 46 minute (17 - 286). Median intensive care unit stay was 1,8 days (0,7 - 27) and the median overall hospital stay was 7,6 days (5,1 - 65). Early postoperative mortality occurred in 1/37 patients (2,7%) with complex neonatal Ross-Konno procedure for HLHS with Turner Syndrome and was non-graft-related. Echocardiography at discharge showed excellent patch function, no signs of device calcification, thrombosis or device failure of the presented cases.

Conclusion: This study demonstrates excellent early results for CardioCel™ patch. Implantation was free of tissue related complications and applicable for manifold indications in complex congenital cardiac repairs.