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Prevention of postoperative pericardial adhesions by closure of the pericardium with absorbable polymer patches. An experimental study

Malm, T LU ; Bowald, S ; Bylock, A and Busch, C (1992) In The Journal of thoracic and cardiovascular surgery 104(3). p.7-600
Abstract

Pericardial adhesions after cardiac operations are a widely known phenomenon. They may severely complicate reoperations, making reentry hazardous, increasing bleeding, and prolonging the operation time. The anatomic orientation and visibility of both bypass grafts and coronary arteries are also impaired. With the aim of minimizing pericardial adhesions after cardiac operations, we studied the course of tissue regeneration after implantation of a new absorbable patch made from poly-hydroxy-butyrate. A total of 23 sheep were studied. Of these, 18 formed the test group and five served as control animals. The animals were killed at intervals of 2 to 30 months after the operation. In 14 of the 18 test animals no adhesions developed. In three... (More)

Pericardial adhesions after cardiac operations are a widely known phenomenon. They may severely complicate reoperations, making reentry hazardous, increasing bleeding, and prolonging the operation time. The anatomic orientation and visibility of both bypass grafts and coronary arteries are also impaired. With the aim of minimizing pericardial adhesions after cardiac operations, we studied the course of tissue regeneration after implantation of a new absorbable patch made from poly-hydroxy-butyrate. A total of 23 sheep were studied. Of these, 18 formed the test group and five served as control animals. The animals were killed at intervals of 2 to 30 months after the operation. In 14 of the 18 test animals no adhesions developed. In three animals loose adhesions were found, and in one with signs of postoperative infection there were moderate, generalized adhesions. All control sheep showed moderate adhesions; no infection was noted in this group. Light microscopy in the test group revealed a layer of mesothelium-like cells facing the epicardial side; this was already present in the early specimens. Poly-hydroxy-butyrate appeared to be slowly phagocytosed by polynucleated macrophages, which were still found occasionally in the late samples. Lymphocytes and platelets were rare. Scanning electron microscopy showed, on the epicardial side of the regenerated tissue, a mesothelium-like lining that completely covered the underlying collagen layer. The surface cell morphology grossly resembled that of native pericardium. It was concluded that in this animal model poly-hydroxy-butyrate pericardial patches decreased adhesions and preserved coronary anatomy. The findings in the control group demonstrated that pericardial surgery in the sheep was associated with adhesion formation.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
6-Ketoprostaglandin F1 alpha/analysis, Animals, Cardiac Surgical Procedures, Follow-Up Studies, Hydroxybutyrates, Microscopy, Electron, Scanning, Pericardium/pathology, Polyesters, Postoperative Complications/prevention & control, Prostheses and Implants, Reoperation, Sheep, Time Factors, Tissue Adhesions/pathology
in
The Journal of thoracic and cardiovascular surgery
volume
104
issue
3
pages
8 pages
publisher
Mosby-Elsevier
external identifiers
  • scopus:0026672568
  • pmid:1513149
ISSN
0022-5223
language
English
LU publication?
no
id
176ce524-3e51-4345-ace0-815e220facf2
date added to LUP
2018-12-05 15:31:39
date last changed
2024-05-14 20:19:36
@article{176ce524-3e51-4345-ace0-815e220facf2,
  abstract     = {{<p>Pericardial adhesions after cardiac operations are a widely known phenomenon. They may severely complicate reoperations, making reentry hazardous, increasing bleeding, and prolonging the operation time. The anatomic orientation and visibility of both bypass grafts and coronary arteries are also impaired. With the aim of minimizing pericardial adhesions after cardiac operations, we studied the course of tissue regeneration after implantation of a new absorbable patch made from poly-hydroxy-butyrate. A total of 23 sheep were studied. Of these, 18 formed the test group and five served as control animals. The animals were killed at intervals of 2 to 30 months after the operation. In 14 of the 18 test animals no adhesions developed. In three animals loose adhesions were found, and in one with signs of postoperative infection there were moderate, generalized adhesions. All control sheep showed moderate adhesions; no infection was noted in this group. Light microscopy in the test group revealed a layer of mesothelium-like cells facing the epicardial side; this was already present in the early specimens. Poly-hydroxy-butyrate appeared to be slowly phagocytosed by polynucleated macrophages, which were still found occasionally in the late samples. Lymphocytes and platelets were rare. Scanning electron microscopy showed, on the epicardial side of the regenerated tissue, a mesothelium-like lining that completely covered the underlying collagen layer. The surface cell morphology grossly resembled that of native pericardium. It was concluded that in this animal model poly-hydroxy-butyrate pericardial patches decreased adhesions and preserved coronary anatomy. The findings in the control group demonstrated that pericardial surgery in the sheep was associated with adhesion formation.</p>}},
  author       = {{Malm, T and Bowald, S and Bylock, A and Busch, C}},
  issn         = {{0022-5223}},
  keywords     = {{6-Ketoprostaglandin F1 alpha/analysis; Animals; Cardiac Surgical Procedures; Follow-Up Studies; Hydroxybutyrates; Microscopy, Electron, Scanning; Pericardium/pathology; Polyesters; Postoperative Complications/prevention & control; Prostheses and Implants; Reoperation; Sheep; Time Factors; Tissue Adhesions/pathology}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{7--600}},
  publisher    = {{Mosby-Elsevier}},
  series       = {{The Journal of thoracic and cardiovascular surgery}},
  title        = {{Prevention of postoperative pericardial adhesions by closure of the pericardium with absorbable polymer patches. An experimental study}},
  volume       = {{104}},
  year         = {{1992}},
}