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Pericardial Closure With Expanded Polytetrafluoroethylene Patch in Left Ventricular Assist Device Surgery
Étienne F R C Meinert1, Jamila Kremer, Ursula Tochtermann
1From the Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 28, 2023
Summary
Using expanded polytetrafluoroethylene (ePTFE) patches for pericardial closure during left ventricular assist device (LVAD) implantation increases mediastinitis risk. However, this approach did not significantly impact overall survival rates in the study cohort.
Area of Science:
- Cardiology
- Medical Devices
- Infectious Disease
Background:
- Pericardial closure with expanded polytetrafluoroethylene (ePTFE) patches is used after left ventricular assist device (LVAD) implantation to reduce adhesions.
- Concerns exist that ePTFE patches, as foreign material, may elevate infectious complication risks.
Purpose of the Study:
- To investigate the outcomes of pericardial closure using ePTFE patches in patients undergoing LVAD implantation.
- To assess the association between ePTFE patch use and the incidence of mediastinitis and overall survival.
Main Methods:
- A single-center retrospective study included 166 patients who underwent LVAD implantation between 2011 and 2020.
- The primary endpoint was mediastinitis development; the secondary endpoint was overall survival.
- Clinical data were collected to compare outcomes between patients with and without ePTFE patch use for pericardial closure.
Main Results:
- Of 166 patients, 116 (70%) received pericardial closure with an ePTFE patch.
- Patients using ePTFE patches showed a significantly higher incidence of mediastinitis (16%) compared to those without (4%) (p = 0.039).
- No significant difference in overall survival was observed between the groups (p = 0.29).
Conclusions:
- Pericardial closure with ePTFE patches during LVAD implantation is associated with an increased risk of mediastinitis.
- The use of ePTFE patches for this indication did not demonstrate a significant impact on overall patient survival.
