Key result
Glutaraldehyde-treated autologous pericardium matches Dacron for reinterventions after infant VSD repair.
Why the study?
Glutaraldehyde-treated autologous pericardium and Dacron are commonly used patch materials for VSD repair in infants, but their comparative effectiveness was unclear.
Does glutaraldehyde-treated autologous pericardium compared to Dacron reduce the need for reintervention for significant residual VSD in infants undergoing repair of isolated VSD?
Cohort (n=156)
No
Does glutaraldehyde-treated autologous pericardium compared to Dacron reduce the need for reintervention for significant residual VSD in infants undergoing repair of isolated VSD?
Absolute Event Rate: 1.8% vs 1%
Glutaraldehyde-treated autologous pericardium is as effective as Dacron for the repair of isolated VSD in infants, with comparable long-term clinical outcomes and hospital charges.
GtAP may be considered for infant VSD repair; leaves open need for prospective trials to confirm equivalence.
OBJECTIVES: Glutaraldehyde-treated autologous pericardium (GtAP) and Dacron™ are 2 patch materials commonly used to repair ventricular septal defects (VSDs) in children. The primary objective of this study was to test the hypothesis that GtAP is as effective as Dacron for the repair of isolated VSD in infants. METHODS: Data were collected retrospectively from all infants who underwent repair of isolated VSD at our institution between January 2009 and April 2017. A total of 156 patients were divided into 2 groups: 99 underwent repair with Dacron patch and 57 with GtAP. The primary end point was the need for reintervention for significant residual VSD. Adjusted hospital charges were also compared. RESULTS: The 2 groups were comparable in their baseline characteristics. There was no significant difference in postoperative morbidity indicators. One patient in each group underwent reintervention for the closure of residual VSD. The GtAP group had a higher incidence trivial and small residual VSD at discharge than the Dacron group (65% vs 39%, P = 0.007). The median duration of follow-up was 37 (15-75) months with no difference between the 2 groups. Forty-five percentage of the residual VSDs in the Dacron group (19/42) and 54%in the GtAP group (21/39) had closed. There was no difference in hospital charges and clinical outcomes. CONCLUSIONS: GtAP for the closure of isolated VSD in infants is comparable to Dacron. Although the incidence of trivial or small residual VSD is higher with the use of pericardium immediately after surgery, this difference disappears over time.
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Desai et al. (2022) conducted a cohort in isolated ventricular septal defect (n=156). Glutaraldehyde-treated autologous pericardium (GtAP) vs. Dacron patch was evaluated on need for reintervention for significant residual VSD. Glutaraldehyde-treated autologous pericardium was comparable to Dacron for isolated VSD repair in infants, with 1.8% vs 1.0% requiring reintervention for significant residual VSD.
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