Pulmonary Arterioplasty With Decellularized Allogeneic Patches

• Published in: The Annals of thoracic surgery Vol. 97; no. 4; pp. 1407 - 1412
• Main Authors: Hopkins, Richard A., MD, Lofland, Gary K., MD, Marshall, Jennifer, MPH, RN, Connelly, Diana, RRT-NPS, CCRC, Acharya, Gayathri, PhD, Dennis, Pamela, RN, CRNFA, Stroup, Richard, McFall, Chris, BS, O'Brien, James E., MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-04-2014
• Subjects: Cardiothoracic Surgery; Child; Child, Preschool; Cryopreservation; Humans; Infant; Infant, Newborn; Prospective Studies; Pulmonary Artery - surgery; Retrospective Studies; Surgery; Transplantation, Homologous; Vascular Surgical Procedures; 21
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2013.12.005

Background Decellularized allogeneic nonvalved pulmonary artery patches for arterioplasty are a relatively new option compared with cryopreserved allogeneic, crosslinked xenogeneic bioprosthetic or synthetic materials. This study examines the midterm experience with a new decellularized allogeneic patch for congenital cardiac reconstructions. Methods For this prospective postmarket approval, nonrandomized, inclusive observational study, we collected data on a consecutive cohort of 108 patients with cardiovascular reconstructions using 120 decellularized allogeneic pulmonary artery patches (MatrACELL; LifeNet Health, Inc, Virginia Beach, VA) between September 2009 and December 2012. One hundred of the patches were used for pulmonary arterioplasties. Two patients were lost early to follow-up and excluded from subsequent survival and durability analyses. Data included demographics, surgical outcomes, subsequent reoperations, and catheter reinterventions. These variables were also collected for an immediately preceding retrospective consecutive cohort of 100 patients with 101 pulmonary arterioplasty patches who received classical cryopreserved pulmonary artery allografts (n = 59 patches and patients) or synthetic materials (n = 41 patients with 42 patches) for pulmonary arterioplasties between 2006 and 2009. Results In 106 patients with 118 decellularized patches, there were no device-related serious adverse events, no device failures, and no evidence of calcifications on chest roentgenograms. In contrast, the prior comparative pulmonary arterioplasty cohort of 100 patients experienced an overall 14.0% patch failure rate requiring device-related reoperations ( p < 0.0001) at mean duration of 194 ± 104 days (range, 25 to 477 days). Conclusions The intermediate-term data obtained in this study suggest favorable performance by decellularized pulmonary artery patches, with no material failures or reoperations provoked by device failure.