Late Aortic Aneurysm After Supravalvar Aortic Stenosis Repaired With Autologous Pericardial Patch

Marco, Ana Lopez; Nawaytou, Omar; Oppell, Ulrich O. von

doi:10.1016/j.athoracsur.2012.05.090

Cited by 11 publications

(6 citation statements)

References 7 publications

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“… 11 Such findings reinforce the concept of the application of the living tissue likely due to the preserved growth and repair potential in such tissues, which may reduce the frequency of the occurrence of stenosis or degenerative changes over time as the patient grows up. 12 In our study, we observed that the untreated pericardial patch maintained its viability and grew appropriately as evidenced by the positivity for viable cell markers and the absence of RVOT stenosis in our long-term follow-up, respectively.…”

Section: Discussionsupporting

confidence: 60%

“…They recommended the fixation of the autologous pericardium with glutaraldehyde before implantation in such situations so as to augment tensile strength and lessen the consequent stretching of the patch and the risk of aneurysm formation. 12 In another case report, the authors described a neonate with VSD as a part of a more complex congenital anomaly who underwent VSD closure with the fresh autologous pericardium and pulmonary artery reconstruction. The case was complicated and was referred for reoperation 4 months later due to an aneurysmal pericardial patch at the site of the VSD repair.…”

Section: Discussionmentioning

confidence: 99%

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The fate of the fresh autologous pericardium after right ventricular outflow tract reconstruction

Tatari

Omrani

Arabian

et al. 2022

J Cardiovasc Thorac Res

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Introduction: The autologous pericardium, treated or fresh, is used in reconstructive cardiovascular surgery. We aimed to describe the features of fresh pericardium utilized in right ventricular outflow tract (RVOT) reconstruction, years after the initial surgery. Methods: This cross-sectional study was performed on 72 patients (65.3% male, mean age =18.68 ± 9.63 y) with a history of RVOT reconstruction with the fresh autologous pericardium who underwent reoperation. During the surgery, a 1 × 1 cm sample was cut from the previous pericardial patch, and hematoxylin and eosin (H & E), Masson’s trichrome, and immunohistochemistry (IHC) staining was conducted. All the stained slides were evaluated,and the descriptive results were explained. Results: The mean follow-up duration was 13.48 ± 7.38 years. In preoperative evaluations,53 (73.6%) patients exhibited no RVOT dilatation, 17 (23.6%) showed mild RVOT dilatation,and 2 (2.8%) had RVOT aneurysms. The H & E staining revealed no calcification in 80.55%(58/72), mild calcification in 9.72% (7/72), and moderate calcification in 9.72% (7/72) of the total samples. None of the specimens demonstrated a marked calcification. All the samples were positive for CD31, CD34, smooth muscle alpha-actin, and von Willebrand factor in IHC. In Masson’s trichrome staining, on average, 64.74% (±18.61) of the tissue sections contained collagen fibers. Conclusion: The fresh autologous pericardium, utilized for RVOT reconstruction, showed viability, growth potential, positivity for endothelial cell markers, vascular differentiation,insignificant calcification, and no stenosis at long-term follow-up. We would, therefore, suggest it as a suitable choice for such reconstructive operations. Moreover, its usage during total correction of tetralogy of Fallot could be safe, feasible, and durable.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

The fate of the fresh autologous pericardium after right ventricular outflow tract reconstruction

Tatari

Omrani

Arabian

et al. 2022

J Cardiovasc Thorac Res

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“…In their opinion, the implementation of pericardium in the systemic pressure increases the possibility of aneurysm formation. To reduce that risk, they have recommended pericardial fixation by immersion in glutaraldehyde before implantation [2]; although it is a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence evaluating the use of pericardium versus prosthetic patches to enlarge the annulus of the aorta to reduce patient–prosthesis mismatch [1]. Therefore, using pericardium became more common because of availability, pliability, resistance to infection, and nonimmunogenicity [2]. Cardiac surgeons utilized it to repair different cardiac defects with satisfactory results, but long-term complications and outcomes remain unclear [3] as its implantation has been reported to be challenging for aortic repair [4].…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac surgeons utilized it to repair different cardiac defects with satisfactory results, but long-term complications and outcomes remain unclear [3] as its implantation has been reported to be challenging for aortic repair [4]. There have been few reports regarding aneurysm development in pericardial patch [2], [4]; however, the proper management and prevention of such a complication is evolving.…”

Section: Introductionmentioning

confidence: 99%

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Aneurysm formation of pericardial patch in Manouguian procedure

Pouraliakbar

Pourmojib

Rezaei

et al. 2018

Journal of the Saudi Heart Association

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Pericardial patch has been used to repair cardiac defects; however, its strength as an aortoplasty patch to tolerate systemic pressure is a matter of debate. We report an aneurysmal dilatation of pericardial patch in aortoplasty. Our patient was a 56-year-old female known case of rheumatic heart disease that underwent redoes mitral and aortic valve replacements along with Manouguian aortoplasty at the age of 44 years old. After 2 months, she was readmitted with a diagnosis of endocarditis. Echocardiography revealed a small cavity in the posterior wall of the aorta. She responded to medical therapy and discharged in a good condition. Twelve years later, she was scheduled to undergo reoperation due to a severe paraprosthetic aortic valve leakage and a pericardial patch aneurysm. The leaking prosthetic aortic valve was explanted and the aneurysmal tissue was replaced with a polyethylene terephthalate patch.

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Enhanced vascular biocompatibility of decellularized xeno-/allogeneic matrices in a rodent model

et al. 2017

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Glutaraldehyde preservation is the gold standard for cardiovascular biological prosthesis. However, secondary calcifications and the absence of tissue growth remain major limitations. Our study assessed in vitro and in vivo the biocompatibility of human (fascia lata, pericardium) and porcine tissues (pericardium, peritoneum) treated with a physicochemical procedure for decellularization and non-conventional pathogens inactivation. Biopsies were performed before and after treatment to assess decellularization (HE/Dapi staining/DNA quantification/MHC I/alpha gal immunostaining) and mechanical integrity. Forty-five rats received an abdominal aortic patch of native cryopreserved tissues (n = 20), treated tissues (n = 20) or glutaraldehyde-preserved bovine pericardium (GBP, control, n = 5). Grafts were explanted at 4 weeks and processed for HE/von Kossa staining and immunohistochemistries for lymphocytes (CD3)/macrophages (CD68) histomorphometry. 95% of decellularization was obtained for all tissues except for fascia lata (75%). Mechanical properties were slightly altered. In the in vivo model, a significant increase of CD3 and CD68 infiltrations was found in native and control implants in comparison with decellularized tissues (p < 0.05). Calcifications were found in 3 controls. Decellularized tissues were recolonized. GBP showed the most inflammatory response. This physicochemical treatment improves the biocompatibility of selected xeno/allogeneic tissues in comparison with their respective native cryopreserved tissues and with GBP. Incomplete decellularization is associated with a significantly higher inflammatory response. Our treatment is a promising tool in the field of tissue decellularization and tissue banking.

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Late Aortic Aneurysm After Supravalvar Aortic Stenosis Repaired With Autologous Pericardial Patch

Cited by 11 publications

References 7 publications

The fate of the fresh autologous pericardium after right ventricular outflow tract reconstruction

The fate of the fresh autologous pericardium after right ventricular outflow tract reconstruction

Aneurysm formation of pericardial patch in Manouguian procedure

Enhanced vascular biocompatibility of decellularized xeno-/allogeneic matrices in a rodent model

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