A comparison of autologous pericardium with Dacron (TM) for closure of ventricular septal defect in infants

OBJECTIVES Glutaraldehyde-treated autologous pericardium (GtAP) and Dacron (TM) 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.