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Long-term evaluation of pericardial substitutes
The Journal of Thoracic and Cardiovascular Surgery
|January 1, 1983
Summary
Bovine pericardium substitutes effectively reduce adhesions and epicardial reactions, facilitating future cardiac reoperations. Synthetic materials showed varied results, with some causing severe reactions that hinder anatomical recognition.
Area of Science:
- Biomaterials Science
- Cardiovascular Surgery
- Regenerative Medicine
Background:
- Postoperative pericardial adhesions complicate cardiac reoperations, increasing risks to cardiac structures.
- Previous pericardial substitutes have yielded inconclusive results in preventing adhesions.
Purpose of the Study:
- To evaluate eight materials (six synthetic, two bovine pericardium preparations) as pericardial substitutes.
- To assess the efficacy of these materials in preventing adhesions and facilitating reoperation.
Main Methods:
- A 10x5 cm pericardial defect was created and patched in 32 dogs.
- Materials were implanted in four dogs each, with euthanasia at 3, 6, 9, and 12 months post-implantation.
- Adhesion development, epicardial reaction, and histology were graded post-autopsy.
Main Results:
- Both bovine pericardium preparations demonstrated excellent results with minimal, easily dissected adhesions and no significant epicardial reaction.
- Silicone rubber-coated polyester fabric was acceptable but caused severe epicardial reaction, obscuring coronary arteries.
- Polytetrafluoroethylene (PTFE) films reduced adhesions but induced severe epicardial reactions.
- Other synthetic materials showed severe epicardial reactions and/or structural deterioration.
Conclusions:
- Bovine pericardium is a highly suitable pericardial substitute, promoting clear anatomical visualization.
- Certain synthetic materials may prevent adhesions but can lead to adverse epicardial reactions, potentially compromising surgical safety.