Application of Double-laycr Pericardial Patch in Reconstruction of The Right Ventricular Outflow Tract

Ö. Sait ATALAY, Melih ERDİNÇ, Ahmet ÖCAL, Ahmet KUZGUN, M. Rakın MİNBAY, Şenol YAVUZ, Muammer AKAR, Selma SEZER, Hüsnü SEZER, I. Ayhan ÖZDEMİR

Bursa Yüksek İhtisas Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bursa

Controversies about the patch material used in reconstruction of the right ventricular outflow tract in infundibular, annular or pulmonary arterial stenoses has not been ceased yet. Non-porosity, relative lack of bleeding at the needle holes and the suturing line, sewing and handling ease, being free of cost, making less flow related hemolysis are the main advantages of autogenous pericardium over prosthetic material. Nevertheless there has been a hesitation in using pericardium, because of the fear from aneurysm formatino, rupture or the other types of patch failure which had been reported especially in cases that the high ventricular-pulmonary arterial gradient couldn't be relieved sufficiently.

As an alternative technique, we used double-layer pericardial patch in 8 cases (5 males) of right ventricular outflow tract reconstruction between February-August 1994. We did not observe any complication related to the pericardial patch. In echocardiographic studies we didn't see any deformity of the right ventricular outflow geometry. We strongly believe that double-layer pericardial patch improves the hemostatic properties of the pericardium and may reduce the risk of aneurysm formation or patch failure in long-term follow-up.

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