Abstract
Complete closure of the pericardial sac after open-heart surgery is thought to be a help in avoiding some postoperative complications and in facilitating reoperation.
Since 1977, sixty-six patients who were subjected to open-heart surgery had glutaraldehyde stabilized xenogeneic bovine pericardial patches inserted to achieve closure of their own pericardial sacs. There were no hemodynamic problems related to the implantation of these patches. All 60 surviving patients were clinically well during a follow-up of 145 patient-years.
Reoperation was undertaken in three patients 2½, 3, and 7 years after the initial operation. The presence of the pericardial patch greatly facilitated the reopening of the chest because it prevented the formation of adhesions between the patch and the epicardium. Histologically, the implanted pericardium consisted of laminae of collagen fibrils containing evenly dispersed fibrocyte nuclei and parallel runs of fairly wide, separated elastic fibrils. There was no evidence of immune reaction.
On the basis of our findings that there was no host reaction or complications after its use, glutaraldehyde stabilized xenogeneic bovine pericardium appears to be the material of choice for patch closure of the pericardium when primary closure alone is not feasible.
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- Asanza L., Rao G., Voleti C., Hartstein M. L., Wisoff B. G. Should the pericardium be closed after an open-heart operation? Ann Thorac Surg. 1976 Dec;22(6):532–534. doi: 10.1016/s0003-4975(10)64471-2. [DOI] [PubMed] [Google Scholar]
- Bonnabeau R. C., Jr, Armanious A. W., Tarnay T. J. Partial replacement of pericardium with dura substitute. J Thorac Cardiovasc Surg. 1973 Aug;66(2):196–201. [PubMed] [Google Scholar]
- Culliford A. T., Cunningham J. N., Jr, Zeff R. H., Isom O. W., Teiko P., Spencer F. C. Sternal and costochondral infections following open-heart surgery. A review of 2,594 cases. J Thorac Cardiovasc Surg. 1976 Nov;72(5):714–726. [PubMed] [Google Scholar]
- Cunningham J. N., Jr, Spencer F. C., Zeff R., Williams C. D., Cukingnan R., Mullin M. Influence of primary closure of the pericardium after open-heart surgery on the frequency of tamponade, postcardiotomy syndrome, and pulmonary complications. J Thorac Cardiovasc Surg. 1975 Jul;70(1):119–125. [PubMed] [Google Scholar]
- Laks H., Hammond G., Geha A. S. Use of silicone rubber as a pericardial substitute to facilitate reoperation in cardiac surgery. J Thorac Cardiovasc Surg. 1981 Jul;82(1):88–92. [PubMed] [Google Scholar]
- Londe S., Sugg W. L. The challenge of reoperation in cardiac surgery. Ann Thorac Surg. 1974 Feb;17(2):157–162. doi: 10.1016/s0003-4975(10)65627-5. [DOI] [PubMed] [Google Scholar]
- MAZUJI M. K., LETT J. C. SILICONIZED DACRON AS A PERICARDIAL PATCH. Arch Surg. 1963 Sep;87:446–449. doi: 10.1001/archsurg.1963.01310150082018. [DOI] [PubMed] [Google Scholar]
- Macmanus Q., Okies J. E., Phillips S. J., Starr A. Surgical considerations in patients undergoing repeat median sternotomy. J Thorac Cardiovasc Surg. 1975 Jan;69(1):138–143. [PubMed] [Google Scholar]
- Nandi P., Leung J. S., Cheung K. L. Closure of pericardium after open heart surgery. A way to prevent postoperative cardiac tamponade. Br Heart J. 1976 Dec;38(12):1319–1323. doi: 10.1136/hrt.38.12.1319. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schechter F. G., Owens R. R., Bryant L. R. Pleural flap closure of pericardial defects following intrapericardial pneumonectomy. Ann Thorac Surg. 1976 Jan;21(1):67–69. doi: 10.1016/s0003-4975(10)64891-6. [DOI] [PubMed] [Google Scholar]
- Youmans C. R., Jr, White J., Derrick J. R. The prevention of pleural and pericardial adhesions with Silastic. J Thorac Cardiovasc Surg. 1968 Mar;55(3):383–388. [PubMed] [Google Scholar]