Comparative studies of prosthetic materials in the left atrium of the dog

Kadowaki, Mark H.; Levett, James M.; Manjoney, Deborah L.; Wilson, Cathyia A.; Glagov, Seymour

doi:10.1007/bf00712741

Cited by 9 publications

(3 citation statements)

References 18 publications

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“…Fibrosis of patches is unusual and reports of bovine pericardium patch fibrosis are distinctly rare. [77,78]. It is likely that the mechanisms that induce patch calcification may be similar to those that induce patch fibrosis, although with subtle differences.…”

Section: Experimental Basis and Clinical Applications Of Bovine Pericardium As A Biomaterialsmentioning

confidence: 99%

Echocardiographic and Computed-tomographic Evaluation of the Fate of Bovine Pericardial Patch as a Pericardial Substitute in Bentall’s Procedure: Twenty-year’ Results

Chowdhury¹,

Goja²,

Sankhyan³

et al. 2022

JCCI

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Objective: The study was designed to ascertain the influence of usage of bovine pericardial patch in patients undergoing Bentall’s procedure with respect to reexploration for bleeding, mediastinal infection, avoidance of conduit adhesions, late development of pericardial constriction and calcification. Materials and Methods: We reviewed 150 patients (79 males) aged between 22 to 68 years (mean±SD 49.25±12.9 years) receiving a composite aortic conduit between January 1998 to December 2020 for annuloaortic ectasia (n=100), aortic dissection (n=49), and dilated aortic root in repaired tetralogy of Fallot (n=1). Twenty-five patients had Marfan’s syndrome. Modified “button technique” was performed by interposing a glutaraldehyde treated pericardial strip at the graft coronary anastomoses, and proximal aortic conduit suturing using interlocking interrupted, pledgeted mattress suture. On completion, the pericardial cavity was reconstructed using St. Jude Medical Biocor pericardial patch. To detect evidence of pericardial constriction, survivors underwent echocardiography and computed tomography. The Kaplan-Meier curve was drawn to show the probability of survival over a period of follow-up time. Results: Seven (4.7%) patients died of cardiac-related cause, 45% had transient hemodynamic instability, 55% had low cardiac output, and 87.1% had spontaneous return of sinus rhythm. The average 12-hour postoperative drainage was 245±70 ml and there was no mediastinal infection. At a mean follow-up of 172.4 (SD± 58.9) months, the actuarial survival was 94.2±0.04% (95% CI: 88.5-96.8), and there was no pericardial constriction or calcification. Conclusion: Reconstruction of pericardial cavity using Biocor bovine pericardial patch minimizes diffuse oozing of blood, graft infection, and is not associated with later development of pericardial constriction, or calcification.

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Section: Experimental Basis and Clinical Applications Of Bovine Pericardium As A Biomaterialsmentioning

confidence: 99%

Echocardiographic and Computed-tomographic Evaluation of the Fate of Bovine Pericardial Patch as a Pericardial Substitute in Bentall’s Procedure: Twenty-year’ Results

Chowdhury¹,

Goja²,

Sankhyan³

et al. 2022

JCCI

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“…Fibrosis of patches is unusual and reports of BP patch fibrosis are distinctly rare (48,49). It is likely that the mechanisms that induce patch calcification are similar to those that induce patch fibrosis, although with subtle differences.…”

Section: Future Directionsmentioning

confidence: 99%

Current Usage and Future Directions for the Bovine Pericardial Patch

Guo

Ziegler

et al. 2011

Annals of Vascular Surgery

150

148

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Bovine pericardium is widely used in surgery and is commonly used for a patch after arteriotomy during cardiovascular surgery. Bovine pericardial patches have several advantages compared to prosthetic patches, including superior biocompatability, easy handling, less suture line bleeding and possibly reduced rates of infection. These advantages of bovine pericardium have led to its common use during carotid endarterectomy. However, long-term clinical results reported after carotid endarterectomy have suggested several issues that may be related to the patch including restenosis, pseudoaneurysm formation, infection, fibrosis, calcification and thrombosis. These complications may diminish the long-term efficacy of carotid endarterectomy and suggest potential areas for improvement of surgical patches. Understanding the mechanisms by which bovine pericardium heals after patch angioplasty may lead to next generation tissue engineered patches.Bovine pericardium (BP) has come into common clinical use during the past 20 years, especially when used as a patch for arterial closure during vascular and cardiac surgery. Bovine pericardial patches possess many technical merits that have led to their widespread adoption in the operating room, including easy handling, less suture bleeding and the ability to immediately perform arterial duplex examination at the site of angioplasty. However, long-term results of this biomaterial are poorly documented and need cautious interpretation as to whether its long term performance is related to the material itself or to the operation in which it is used. For example, it is unclear whether restenosis after carotid endarterectomy is directly related to the patch itself or whether restenosis is an inevitable consequence of the arterial procedure. In addition, there are sporadic reports of unusual complications with BP patches, including patch rupture and cartilaginous metaplasia. Although these reports are Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. unusual, careful examination of these potential areas of improvement may lead to future generations of BP patches with superior performance. NIH Public AccessThe native structure of bovine pericardium has three layers: 1) the serosa, the inner thin layer consisting of mesothelial cells; 2) the fibrosa, the thicker layer formed by diversely oriented, wavy bundles of collagen and elastin; and 3) the epipericardial connective tissue layer, the outer layer that is partly continuous with the pericardiosternal ligaments. Commercially available patches are processed to be acellular, preventing transpl...

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“…complications were common and independent from the type of substitute (10,11). Furthermore, the distribution of calcific foci was reported as strongly correlated to implantation site, function, and bloodstream contact with these patches (8,9).…”

Section: Introductionmentioning

confidence: 99%

Bioengineered tissue solutions for repair, correction and reconstruction in cardiovascular surgery

Iop¹,

Palmosi²,

Sasso³

et al. 2018

J. Thorac. Dis.

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The treatment of cardiac alterations is still nowadays a dramatic issue in the cardiosurgical practice. Synthetic materials applied in this surgery have failed in their long-term therapeutic efficacy due to low biocompatibility and compliance, especially when used in contractile sites. In order to overcome these treatment pitfalls, novel solutions have been developed based on biological tissues. Patches in pericardium, small intestinal submucosa, as well as engineered tissues of myocardium, heart valves and blood vessels have undergone a large preclinical investigation in regenerative medicine studies. Clinical translation has been started or reached by several of these new bioengineered treatment alternatives. This review will describe the preclinical and clinical experiences realized so far with the application of biological tissues in cardiovascular surgery. It will depict the progressive steps realized in the evolution of this research, as well as it will point out the challenges yet to face in order to generate the ideal biomaterial for cardiovascular repair, corrective and reconstructive surgery.

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Comparative studies of prosthetic materials in the left atrium of the dog

Cited by 9 publications

References 18 publications

Echocardiographic and Computed-tomographic Evaluation of the Fate of Bovine Pericardial Patch as a Pericardial Substitute in Bentall’s Procedure: Twenty-year’ Results

Echocardiographic and Computed-tomographic Evaluation of the Fate of Bovine Pericardial Patch as a Pericardial Substitute in Bentall’s Procedure: Twenty-year’ Results

Current Usage and Future Directions for the Bovine Pericardial Patch

Bioengineered tissue solutions for repair, correction and reconstruction in cardiovascular surgery

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