Repeat sternotomy after reconstruction of the pericardial sac with glutaraldehyde-preserved equine pericardium

Details

Serval ID
serval:BIB_7814D03D35AE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Repeat sternotomy after reconstruction of the pericardial sac with glutaraldehyde-preserved equine pericardium
Journal
Journal of Thoracic and Cardiovascular Surgery
Author(s)
von Segesser  L., Jornod  N., Faidutti  B.
ISSN
0022-5223
Publication state
Published
Issued date
04/1987
Peer-reviewed
Oui
Volume
93
Number
4
Pages
616-9
Notes
Comparative Study
Journal Article --- Old month value: Apr
Abstract
The risk of repeat sternotomy is higher than that of the initial sternotomy, especially if the pericardial sac was left open at the first intervention. In 200 consecutive patients with a pericardial defect after open heart operations, the pericardium was closed with a glutaraldehyde-preserved equine pericardial patch. Precardiac adhesions at reoperation were assessed in four groups of patients on a scale of 6, ranging from 0 (no adhesions) to 5 (calcified or ossified adhesions). Group I comprised 13 patients in whom the pericardium was left open at the first operation and an equine pericardial patch was implanted at reoperation. Group Ia included the first five Group I patients who underwent reoperation less than 1 year (early reoperation) after the initial procedure. Group Ib included the other eight patients of Group I, who underwent reoperation more than 1 year (late reoperation) after the first procedure. Group II comprised nine patients who were reoperated on after reconstruction of the pericardial sac with a glutaraldehyde-preserved equine pericardial patch. After a mean follow-up of 20.2 months, the incidence of patch-related complications was 1%. Statistical analysis shows less severe adhesions on reoperation in Group II patients (pericardial defect patched) than in Group I patients (pericardial defect left open): mean grade of adhesions 1.6 +/- 0.9 (Group II) versus 3.2 +/- 0.6 (Group I), p less than 0.001. Precardial adhesions with the pericardium left open were similar in patients having early and late reoperations: mean grade of adhesions 3.0 +/- 0.7 (Group Ia) versus 3.4 +/- 0.5 (Group Ib), no significant difference. Therefore, the glutaraldehyde-preserved equine pericardial patch can be considered a suitable material for primary closure of the pericardial sac in patients with inadequate autologous pericardium.
Keywords
Adhesions/etiology Adolescent Adult Animals Bioprosthesis/*adverse effects Cardiomyopathies/*etiology Child Child, Preschool Female Glutaral Horses Humans Infant Male Pericardium/*transplantation Reoperation Sternum/*surgery Tissue Preservation Transplantation, Heterologous
Pubmed
Web of science
Create date
14/02/2008 14:16
Last modification date
20/08/2019 14:34
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