The Use of the CardioCel 3D 60° Patch for Aortic Arch Reconstruction in Infancy - A Word of Caution

Authors

Alyssia Venna, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Mahmut Öztürk, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Justus Reitz, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
In Hye Park, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Sofia Hanabergh, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Arif Selcuk, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Aybala Tongut, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Manan Desai, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Yves d'Udekem, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC.
Can Yerebakan, Division of Cardiac Surgery, Children's National Hospital, The George Washington University, Washington DC. Electronic address: cyerebakan@childrensnational.org.

Document Type

Journal Article

Publication Date

6-25-2024

Journal

The Annals of thoracic surgery

DOI

10.1016/j.athoracsur.2024.06.012

Abstract

BACKGROUND: There is limited data on outcomes following implantation of Cardiocel 3D 60° patch in great vessel repair. After anecdotally witnessing an increase in negative outcomes, we reviewed our experience using this patch in our neonate and infant patients undergoing aortic arch repair. METHODS: A total of 24 patients underwent aortic arch repair with implantation of CardioCel 3D 60° patch between July 2018 to July 2021. Dominant cardiac morphologies were Hypoplastic Left Heart Syndrome (66%), Atrioventricular Canal defects (13%) and Other (21%). Median age at implantation was 44 days (IQR 6-112). Recurrent obstruction was defined as need for reoperation or catheter intervention or recurrent peak pressure gradient of descending aorta ≥ 25 mm Hg on echocardiography. RESULTS: Five deaths occurred after median 217 days (IQR 69-239). Twelve patients (50%) had recurrent obstruction. Three patients (13%) required redo aortic arch operation after a median of 148 days (IQR 128-193), with extensive fibrous coating of the patch interior causing obstruction. Eleven patients (46%) required at least one balloon angioplasty on their aorta after a median of 102 days (IQR 83-130) following repair, and three needed more than one catheter intervention. The estimated probability of having recurrent obstruction at 6 months was 85% and at 1 year follow up was 71% (p=0.06). CONCLUSIONS: Recurrent aortic obstruction occurred in half of our patients shortly after repair. The use of the CardioCel 3D 60° patch for aortic arch reconstruction in neonates and infants should be re-evaluated.

APA Citation

Venna, Alyssia; Öztürk, Mahmut; Reitz, Justus; Park, In Hye; Hanabergh, Sofia; Selcuk, Arif; Tongut, Aybala; Desai, Manan; d'Udekem, Yves; and Yerebakan, Can, "The Use of the CardioCel 3D 60° Patch for Aortic Arch Reconstruction in Infancy - A Word of Caution" (2024). GW Authored Works. Paper 5050.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5050

Department

Surgery