CardioCel® for repair of congenital heart defects: nationwide results of over 1000 implants

Abstract

Abstract OBJECTIVES To assess the mid-term performance of CardioCel for the repair of congenital heart defects. METHODS Data were retrospectively collected from databases and hospital records in 3 congenital cardiac surgery centres in Australia. Kaplan–Meier curves and log-rank tests were used to test for associations between patient age, gender, patch type and site of implantation. Multivariable Cox regression was used to test whether any specific implantation site was associated with reintervention risk, after adjusting for age group, gender and patch type. RESULTS A total of 1184 CardioCel patches were implanted in 752 patients under the age of 18 years. Median age at implant was 12 months [interquartile range (IQR) 3.6–84]. Median follow-up was 2.1 years (IQR 0.6–4.6). Probability of freedom from CardioCel-related reintervention was 93% [95% confidence interval (CI) 91–95] at 1 year, 91% (95% CI 88–93) at 3 years and 88% (95% CI 85–91) at 5 years, respectively. On multivariable regression analysis, aortic valve repair had a higher incidence of reintervention [hazard ratio (HR) = 7.15, P = 0.008] compared to other sites. The probability of reintervention was higher in neonates (HR = 6.71, P = 0.0007), especially when used for augmentation of the pulmonary arteries (HR = 14.38, P = 0.029), as compared to other age groups. CONCLUSIONS CardioCel can be used for the repair of a variety of congenital heart defects. In our study, in patients receiving a CardioCel implant, reinterventions were higher when CardioCel was used to augment the pulmonary arteries in neonates and for aortic valve repair as compared to other sites.