Closure of the pericardium using expanded polytetrafluoroethylene GORE-TEX-Surgical Membrane: clinical experience

Complete closure of the pericardium after cardiac operation would have the advantage of avoiding injury of the heart and great vessels should repeat sternotomy prove to be necessary. In such situations, various pericardial closure techniques have been described. Synthetic materials produced severe scarring, while xenografts appeared to be satisfactory, although fibrous reactions and aseptic cystic formations have been reported recently. Between 1985 and 1986 we closed the pericardium with GORE-TEX-Surgical Membrane in a selected series of 72 patients aging 1 month to 76 years, median 24 years. Overall hospital mortality was 3/72 cases. In no instance was there a relationship between death occurrence and pericardial closure through Surgical Membrane. There were 5 cases each of low cardiac output and rethoracotomy because of bleeding. No cardiac tamponade occurred. Two patients had to be reoperated three and four weeks after primary repair. Surgical Membrane was explanted. Electron microscopy examination showed no cellular ingrowth in the low porosity membrane. No immunocompetent cellular compounds were present on either side of the graft. Follow-up interval averaged 13 months. No complication related to pericardial closure has occurred until now. The Surgical Membrane has the advantages of easy availability, of lack of reactions both between its surface and the underlying epicardium and with the rest of the pericardium. We believe its routine use should be encouraged mainly in patients with high probability of reoperation.