Bovine pericardium patch repairs heart defects and aerosolized iloprost reduces pulmonary hypertension / 中国组织工程研究

ABSTRACT

BACKGROUND:The treatment of pulmonary hypertension secondary to congenital heart disease has been a hot topic in the clinical research on cardiac surgery. Although traditional drugs for reducing pulmonary hypertension have excelent effects, there are some defaults, such as difficult monitoring and rebounding phenomenon after drug withdrawal. The traditional heart dacron graft is prone to cause complications, such as deformation, thrombosis, embolism, hemolysis and infection. OBJECTIVE:To investigate the effect of glutaraldehyde-fixed bovine pericardium patch and aerosolized iloprost in patients with pulmonary hypertension secondary to congenital heart disease. METHODS:Ninety patients with pulmonary hypertension due to congenital heart disease underwent a surgery. Glutaraldehyde-treated bovine pericardium patch were used to repair cardiac septal defect, and then aerosolized iloprost was applied after operation, administered for 3 days according to 30 ng/min/kg, every 4 hours in the first 12 hours of a day, and every 6 hours in the resting 12 hours. Mean arterial pressure, mean pulmonary arterial pressure, systemic vascular resistance index, pulmonary vascular resistance index were recorded before inhalation, immediately after inhalation, and 30 minutes after inhalation. The pericardium-associated complications, and cardiac function were also observed at folow-ups. RESULTS AND CONCLUSION: The involved 90 cases were detected by echocardiography. The results showed that, al the flaps were closed, there was no shunting or echo discontinuation of atrial septum. The heart contraction function was normal. No pericardium-associated complications were found. There was no significant difference in the mean arterial pressure and systemic vascular resistance index in al patients at different time points. The mean pulmonary arterial pressure and pulmonary vascular resistance index immediately after inhalation were significantly lower than that before inhalation (P < 0.01). The decrease was also significant 30 minutes after inhalation (P < 0.05). The intervention of glutaraldehyde-fixed bovine pericardium patch and aerosolized iloprost is safe and effective to treat patients with pulmonary hypertension secondary to congenital heart disease.