Hemashield implantation in young patients with congenital cardiovascular lesions

Background. There is substantial controversy regarding the use of Hemashiel d in young patients. Methods. Twenty-one consecutive patients younger than 20 years of age with a variety of congenital cardiovascular lesions underwent surgical procedure s using a Hemashield woven graft. Hemashield was used for reconstruction of the aortic wall (n = 16), ventricular septum (n = 10), and right ventricul ar 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 concent ration for up to 4 weeks after implantation. Multivariable analysis identif ied the use of Hemashield in the right ventricular free wall or pulmonary a rtery as an incremental risk factor for elevation of plasma C-reactive prot ein concentration during the first 3 weeks after implantation (p = 0.002). There were no midterm complications including restenosis of the grafts in t he right ventricular outflow tract. Conclusions. Hemashield can be used in a variety of situations for reconstr uction 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 h eart. (C) 2000 by The Society of Thoracic Surgeons.