Replacement of the ascending aorta and aortic arch with bovine pericardial graftsA preliminary report

Abstract

Bovine pericardial (BP) grafts have been clinical use at Biocor Hospital since 1989 for replacement or repair of the ascending aorta (AsAo) and initial segment of the aortic arch (AoAr). The main advantages of BP grafts that have justified their clinical application are much easier surgical technique, perfect hemostasis and low cost. From Feb/89 to Feb/94, 88 BP grafts were implanted in the AsAo or the AoAr. There were 33 valved conduits, 47 non-valved conduits and 8 patches. The main indication for the procedure was acute dissection of the aorta, accounting for 50% of the cases. The total hospital mortality was 20.4%. Follow-up was obtained in all but two patients. Patients who survived 2 or more years postoperatively (n = 31) underwent either an echocardiographic or an angiographic study in order to access the behavior of the graft, which was perfect in all of them. The current follow-up is short and complications such as calcification may still develop. However the present study has clearly shown the superior handling and better hemostasis of BP grafts compared to the classical Dacron prosthesis.

Pseudo-aneurisma em tubo valvulado de pericárdio bovino corrugado após reconstrução da aorta ascendente: relato de caso

“…A utilização do pericárdio bovino como material protético na correção de defeitos congênitos apresenta, como vantagens, menor custo, impermeabilidade, maleabilidade e flexibilidade do tecido, tornando as linhas de sutura mais hemostáticas (2,3,11) . SALLES et al (4) desenvolveram um tubo corrugado de pericárdio bovino como alternativa ao Dacron.…”

“…SALLES et al (4) desenvolveram um tubo corrugado de pericárdio bovino como alternativa ao Dacron. O pericárdio bovino, mesmo quando conservado em glutaraldeído, apresenta como maiores inconvenientes a calcificação e a formação de aneurismas a longo prazo (11)(12)(13) . No entanto, KALIL et al (14) , avaliando tardiamente (tempo de seguimento de 2 a 7 anos) pacientes onde se utilizou o tubo de pericárdio para o tratamento de doenças da aorta, não relatam o aparecimento de calcificações ou pseudo-aneurismas, relatando, em 40% dos casos, dilatação moderada do enxerto.…”

Aortic reconstruction with bovine pericardial grafts

“…Bovine pericardium grafts constitute an attractive alternative to synthetic fibers resulting in an easy-to-use graft which is simple to handle especially during specific operative maneuvers, such as the reimplantation of coronary artery ostia [1]. Reports of the use of this material have been described throughout the world, stressing the practical nature of its intra-operative use and the few intra-operative complications related to bleeding [1,2]. Malashenkov et al [3] described a series of 145 patients who used bovine pericardial grafts in aorta replacement, with complications related to the grafts in only four cases over the long-term.…”

“…Their use is noteworthy in the intraoperative period for the ease of handling, good homeostatic characteristics, absence of the necessity of specific precoagulant treatment and low thrombogenicity [1,2]. Over the long term they have been demonstrated as having a low complication rate, including infections, thrombosis and bleeding [3].…”

“…aortic prostheses, valved tubes, etc.) has also assisted in the popularity of these materials for aorta replacement operations and their use in substituting synthetic materials such as Dacron [1]. The objective of this study is to analyze the immediate and long-term postoperative results after the use of different crimped bovine pericardial grafts in aorta replacement surgeries, with particular emphasis on the safety of the grafts and longterm complications.…”