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Ann Thorac Surg 2000;69:1920-1924
© 2000 The Society of Thoracic Surgeons

Original articles: Cardiovascular

Hemashield implantation in young patients with congenital cardiovascular lesions

Ryo Aeba, MDa, Toshiyuki Katogi, MDa, Shiaki Kawada, MDa

a Division of Cardiovascular Surgery, Keio University, Tokyo, Japan

Address reprint requests to Dr Aeba, Division of Cardiovascular Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
e-mail: aeba{at}mc.med.keio.ac.jp

Background. There is substantial controversy regarding the use of Hemashield in young patients.

Methods. Twenty-one consecutive patients younger than 20 years of age with a variety of congenital cardiovascular lesions underwent surgical procedures using a Hemashield woven graft. Hemashield was used for reconstruction of the aortic wall (n = 16), ventricular septum (n = 10), and right ventricular free wall or pulmonary artery (n = 6).

Results. A sterile inflammatory reaction was observed including high fever, increased white cell count, and elevated plasma C-reactive protein concentration for up to 4 weeks after implantation. Multivariable analysis identified the use of Hemashield in the right ventricular free wall or pulmonary artery as an incremental risk factor for elevation of plasma C-reactive protein concentration during the first 3 weeks after implantation (p = 0.002). There were no midterm complications including restenosis of the grafts in the right ventricular outflow tract.

Conclusions. Hemashield can be used in a variety of situations for reconstruction of congenital cardiovascular lesions in young patients. Impregnated collagen can cause a significant systemic inflammatory reaction for several weeks after implantation, especially when used in the low-pressure right heart.


Related Article

Invited commentary
Carl L. Backer and Constantine Mavroudis
Ann. Thorac. Surg. 2000 69: 1924-1925. [Extract] [Full Text] [PDF]





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