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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
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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
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Copyright
© Cambridge University Press 2017 

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