Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-16T14:54:17.676Z Has data issue: false hasContentIssue false
  • English
  • Français

Right ventricular function after repair of tetralogy of Fallot: a comparison between bovine pericardium and porcine small intestinal extracellular matrix

Published online by Cambridge University Press:  29 May 2017

Ronak Naik ,
Jason Johnson ,
T. K. S. Kumar ,
Ranjit Philip ,
Umar Boston  and
Christopher J. Knott-Craig
Ronak Naik*
Affiliation:
Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
Jason Johnson
Affiliation:
Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
T. K. S. Kumar
Affiliation:
Cardiothoracic Surgery, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
Ranjit Philip
Affiliation:
Division of Pediatric Cardiology, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
Umar Boston
Affiliation:
Cardiothoracic Surgery, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
Christopher J. Knott-Craig
Affiliation:
Cardiothoracic Surgery, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis, Tennessee, United States of America
*
Correspondence to: Assistant Professor R. Naik, MD, DNB, FACC, Department of Pediatrics, Division of Cardiology, University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, 49 N Dunlap Avenue, Level 3, Memphis, TN, 38105, United States of America. Tel: +1 901 287 6380; Fax: +1 901 287 5970; E-mail: Ronak.naik@lebonheur.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The porcine small intestinal extracellular matrix reportedly has the potential to differentiate into viable myocardial cells. When used in tetralogy of Fallot repair, it may improve right ventricular function. We evaluated right ventricular function after repair of tetralogy of Fallot with extracellular matrix versus bovine pericardium.

Method

Subjects with non-transannular repair of tetralogy of Fallot with at least 1 year of follow-up were selected. The extracellular matrix and bovine pericardium groups were compared. We used three-dimensional right ventricular ejection fraction, right ventricle global longitudinal strain, and tricuspid annular plane systolic excursion to assess right ventricular function.

Results

The extracellular matrix group had 11 patients, whereas the bovine pericardium group had 10 patients. No differences between the groups were found regarding sex ratio, age at surgery, and cardiopulmonary bypass time. The follow-up period was 28±12.6 months in the extracellular matrix group and 50.05±17.6 months in the bovine pericardium group (p=0.001). The mean three-dimensional right ventricular ejection fraction (55.7±5.0% versus 55.3±5.2%, p=0.73), right ventricular global longitudinal strain (−18.5±3.0% versus −18.0±2.2%, p=0.44), and tricuspid annular plane systolic excursions (1.59±0.16 versus 1.59±0.2, p=0.93) were similar in the extracellular matrix group and in the bovine pericardium group, respectively. Right ventricular global longitudinal strain in healthy children is reported at −29±3% in literature.

Conclusion

In a small cohort of the patients undergoing non-transannular repair of tetralogy of Fallot, there was no significant difference in right ventricular function between groups having extracellular matrix versus bovine pericardium patches followed-up for more than 1 year. Lower right ventricular longitudinal strain noted in both the groups compared to healthy children.

Keywords

Tetralogy of Fallotporcine small intestinal extracelluar matrixright ventricular function
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1522 - 1528
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Van Praagh, R, Etienne-Louis, A. Fallot and his tetralogy: a new translation of Fallot’s summary and a modern reassessment of this anomaly. Eur J Cardiothorac Surg 1989; 3: 381–386.CrossRefGoogle Scholar
2. Geva, T. Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson 2011; 13: 9.CrossRefGoogle ScholarPubMed
3. Parks, WJ, Ngo, TD, Plauth, WH, et al. Incidence of aneurysm formation after Dacron patch aortoplasty repair for coarctation of the aorta: long-term results and assessment utilizing magnetic resonance angiography with three-dimensional surface rendering. J Am Coll Cardiol 1995; 26: 266–271.CrossRefGoogle ScholarPubMed
4. Badylak, SF, Freytes, DO, Gilbert, TW. Extracellular matrix as a biological scaffold material: structure and function. Acta Biomater 2009; 5: 1–13.CrossRefGoogle ScholarPubMed
5. Zhao, ZQ, Puskas, JD, Xu, D, et al. Improvement in cardiac function with small intestine extracellular matrix is associated with recruitment of C-kit cells, myofibroblasts, and macrophages after myocardial infarction. J Am Coll Cardiol 2010; 55: 1250–1261.CrossRefGoogle ScholarPubMed
6. Mirensky, TL, Breuer, CK. The development of tissue-engineered grafts for reconstructive cardiothoracic surgical applications. Pediatr Res. 2008; 63: 559–568.CrossRefGoogle ScholarPubMed
7. Boyd, WD, Johnson, WEr, Sultan, PK, et al. Pericardial reconstruction using an extracellular matrix implant correlates with reduced risk of postoperative atrial fibrillation in coronary artery bypass surgery patients. Heart Surg Forum 2010; 13: E311–E316.CrossRefGoogle ScholarPubMed
8. Calvano, CJ, Moran, ME, Parekh, A, et al. Laparoscopic augmentation cystoplasty using the novel biomaterial Surgisis: small-intestinal submucosa. J Endourol 2000; 14: 213–217.CrossRefGoogle ScholarPubMed
9. Chen, F, Yoo, JJ, Atala, A. Acellular collagen matrix as a possible “off the shelf” biomaterial for urethral repair. Urology 1999; 54: 407–410.CrossRefGoogle ScholarPubMed
10. Mor-Avi, V, Lang, RM, Badano, LP, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr 2011; 24: 277–313.CrossRefGoogle ScholarPubMed
11. Lang, RM, Badano, LP, Mor-Avi, V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28: 1–39.e14.CrossRefGoogle ScholarPubMed
12. Bacha, EA, Scheule, AM, Zurakowski, D, et al. Long-term results after early primary repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 2001; 122: 154–161.CrossRefGoogle ScholarPubMed
13. Oosterho, T, Straten, AV, Vliegen, HW, et al. Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance. Circulation 2007; 116: 545–551.CrossRefGoogle Scholar
14. Us, MH, Sungun, M, Sanioglu, S, et al. A retrospective comparison of bovine pericardium and polytetrafluoroethylene patch for closure of ventricular septal defects. J Int Med Res 2004; 32: 218–221.CrossRefGoogle ScholarPubMed
15. Li, RK, Jia, ZQ, Weisel, RD, et al. Cardiomyocyte transplantation improves heart function. Ann Thorac Surg, 62: 654–661.CrossRefGoogle Scholar
16. Tomita, S, Li, RK, Weisel, RD, et al. Autologous transplantation of bone marrow cells improves damaged heart function. Circulation 1999; 100: II247–II256.CrossRefGoogle ScholarPubMed
17. Taylor, DA, Atkins, BZ, Hungspreugs, P, et al. Regenerating functional myocardium: improved performance after skeletal myoblast transplantation. Nat Med 1998; 4: 929–933.CrossRefGoogle ScholarPubMed
18. Scully, BB, Fan, C, Grigoryan, B, et al. Remodeling of ECM patch into functional myocardium in an ovine model: a pilot study. J Biomed Mater Res B Appl Biomater 2016; 104: 1713–1720.CrossRefGoogle Scholar
19. Zantop, T, Gilbert, TW, Yoder, MC, et al. Extracellular matrix scaffolds are repopulated by bone marrow-derived cells in a mouse model of achilles tendon reconstruction. J Orthop Res 2006; 24: 1299–1309.CrossRefGoogle Scholar
20. Lopes, MF, Cabrita, A, Ilharco, J, et al. Esophageal replacement in rat using porcine intestinal submucosa as a patch or a tube-shaped graft. Dis Esophagus 2006; 19: 254–259.CrossRefGoogle ScholarPubMed
21. Woo, JS, Fishbain, MC, Reemtsen, B, et al. Histologic examination of decellularized porcine intestinal submucosa extracellular matrix (CorMatrix) in pediatric congenital heart surgery. Cardiovasc Pathol 2016; 25: 12–17.CrossRefGoogle ScholarPubMed
22. Nelson, JS, Haider, A, Si, MS, et al. Evaluation of explanted CorMatrix intracardiac patches in children with congenital heart disease. Ann Thorac Surg 2016; 102: 1329–1335.CrossRefGoogle ScholarPubMed
23. Zaidi, AH, Nathan, M, Emani, S, et al. Preliminary experience with porcine intestinal submucosa (CorMatrix) for valve reconstruction in congenital heart disease: histologic evaluation of explanted valves. J Thorac Cardiovasc Surg 2014; 148: 2216–2214, 2225.e2211.CrossRefGoogle ScholarPubMed
24. Rosario-Quinones, F, Magid, MS, Yau, J, et al. Tissue reaction to porcine intestinal submucosa (CorMatrix) implants in pediatric cardiac patients: a single-center experience. Ann Thorac Surg 2015; 99: 1373–1377.CrossRefGoogle ScholarPubMed
25. Rudski, LG, Lai, WW, Afilalo, J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23: 685–713; quiz 786–688.CrossRefGoogle Scholar
26. Koestenberger, M, Nagel, B, Favekes, W, et al. Systolic right ventricular function in pediatric and adolescent patients with tetralogy of Fallot: echocardiography versus magnetic resonance imaging. J Am Soc Echocardiogr 2011; 24: 45–52.CrossRefGoogle ScholarPubMed
27. Solarz, DE, Witt, SA, Glascock, BJ, et al. Right ventricular strain rate and strain analysis in patients with repaired tetralogy of Fallot: possible interventricular septal compensation. J Am Soc Echocardiogr 2004; 17: 338–344.CrossRefGoogle ScholarPubMed
28. Levy, PT, Sanchez-Mejia, AA, Machefsky, A, et al. Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2014; 27: 549–560, e543.CrossRefGoogle ScholarPubMed