Equine pericardium: a versatile alternative reconstructive material in congenital cardiac surgery

Abstract

Background Pericardial patches are often used for repair of congenital cardiac defects. The aim of this study was to describe our initial experience with the use of equine pericardium and its safety and advantages and disadvantages compared to bovine pericardium. Methods We designed a retrospective cohort study of 111 patients who were surgically treated for congenital heart disease between 2017 and 2020. Equine pericardium was used in 58 patients and bovine pericardium was used in 53 patients. Recorded variables included demographic data, preoperative cardiac pathology, site of patch insertion, morbidity and mortality. Results The overall survival rate was 94.5% and no deaths were related to patch insertion. None of our patients were reoperated on for patch related complications. Postoperative transcatheter intervention was needed in 2 patients (1.8%): one for dilatation of aortic arch stenosis after repair of hypoplastic left heart syndrome with equine pericardium and one for dilatation of pulmonary artery branches after repair of tetralogy of Fallot using bovine pericardium. Conclusions Equine pericardium is a safe patch material for reconstruction in congenital heart surgery. It may be preferable to bovine pericardium in cases requiring a complex shape or a pliable patch as in in arch reconstruction or for valve reconstruction.

A New Detergent for the Effective Decellularization of Bovine and Porcine Pericardia

“…In the context of regenerative medicine, there is a growing need for biomaterials that not only possess adequate biocompatibility and functional features, but are also able to integrate with and grow in the recipient’s body. To date, pericardial tissues have been used in reconstructive surgery [ 1 , 2 , 3 ] and, in particular, the main applications of bovine and porcine pericardia aim at producing bioprostheses for the surgical management of cardiovascular congenital and acquired defects [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

A High-biocompatibility Interface for the Breast Implant: First Report of a Novel Biological Matrix–assisted Technique in Aesthetic Revision Surgery

“… 7 According to a 2021 study, equine pericardium is considered thinner, easier to handle and remodel in proper shape than bovine pericardium. 10 In fact, Berna et al have discussed equine pericardium as attractive for breast surgery, given the superior strength of equine pericardial collagen fibers arranged in such a thin layer, excellent for obtaining regenerative implants with minimal thickness. 7 Compactness of APM collagen fibers guides a gradual remodeling process that makes bioactive physiological components available, modulating angiogenesis, cell proliferation and orientation in regenerative healing.…”

Grafts and Patches: Optimized but Not Optimal Materials for Congenital Heart Surgery

“…The use of equine pericardium is justified by animal studies in which neither negative structural changes nor calcifications could be detected [ 55 ]. A recently published retrospective cohort study showed first good short-term clinical results [ 56 ], although no systematic distinctions were made between implantation site and congenital heart defect.…”