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Open J Cardiovasc Surg. 2017 Jul 17;9:1179065217720909. doi: 10.1177/1179065217720909. eCollection 2017.

Postoperative Pericardial Adhesion Prevention Using Collagen Membrane in Pigs: A Pilot Study.

Open journal of cardiovascular surgery

Noppon Taksaudom, Metus Ketwong, Nirush Lertprasertsuke, Aphisek Kongkaew

Affiliations

  1. Department of Surgery, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
  2. Department of Pathology, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
  3. Animal House Unit, Research Administration Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

PMID: 28781517 PMCID: PMC5518959 DOI: 10.1177/1179065217720909

Abstract

OBJECTIVE: The operating procedure of a resternotomy in open-heart surgery is a complicated procedure with potentially problematic outcomes partly due to potential adhesions in the pericardial cavity and retrosternal space. Use of a collagen membrane has shown encouraging results in adhesion prevention in several regions of the body. This study was designed to evaluate the effectiveness of the use of this collagen membrane in the prevention of pericardial adhesions.

MATERIALS AND METHODS: A total of 12 pigs were divided randomly into 2 groups: an experimental group in which collagen membranes were used and a control group. After sternotomy and an anterior pericardiectomy, the epicardial surface was exposed to room air and irrigated with saline, and an epicardial abrasion was performed using a sponge. The pericardial defect was repaired using a collagen membrane in the experimental group or left uncovered in the control group. After 8 to 12 weeks, the pigs were killed, and a resternotomy was performed by a single-blinded surgeon enabling the evaluation of adhesions. The heart was then removed and sent for microscopic assessment conducted by a single-blinded pathologist.

RESULTS: The resternotomy operations performed using a collagen membrane demonstrated a nonstatistically significant trend of fewer macroscopic and microscopic adhesions in all regions (

CONCLUSIONS: This study showed nonstatistically significant differences between the outcomes in the collagen membrane group and the control group in both macroscopic and microscopic adhesion prevention. Due to the many limitations in animal study design, further studies in human models will be needed before the true value of this procedure can be evaluated.

Keywords: Mediastinum; experimental cardiac surgery; pericardium

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

  1. J Surg Res. 2007 Jun 15;140(2):237-42 - PubMed
  2. Acta Cir Bras. 2009 Mar-Apr;24(2):82-6 - PubMed
  3. Cardiovasc Ultrasound. 2010 Sep 22;8:42 - PubMed
  4. ASAIO Trans. 1990 Oct-Dec;36(4):789-91 - PubMed
  5. Eur J Obstet Gynecol Reprod Biol. 2010 Apr;149(2):131-5 - PubMed
  6. Interact Cardiovasc Thorac Surg. 2005 Aug;4(4):356-9 - PubMed
  7. Fertil Steril. 2000 Jan;73(1):157-61 - PubMed
  8. J Surg Res. 2003 Mar;110(1):207-10 - PubMed
  9. Thorac Cardiovasc Surg. 1995 Dec;43(6):338-46 - PubMed
  10. Nat Rev Cardiol. 2011 Jan;8(1):50-60 - PubMed
  11. J Surg Res. 2011 Apr;166(2):206-13 - PubMed
  12. Ann Thorac Surg. 2013 Jan;95(1):183-8 - PubMed
  13. Circulation. 2011 Feb 1;123(4):e18-e209 - PubMed
  14. J Am Coll Cardiol. 2005 Jul 5;46(1):1-8 - PubMed
  15. J Thorac Cardiovasc Surg. 1984 Apr;87(4):539-42 - PubMed
  16. Circulation. 2011 Mar 1;123(8):841-9 - PubMed
  17. Arch Cardiovasc Dis. 2013 Aug-Sep;106(8-9):433-9 - PubMed
  18. Ann Thorac Surg. 2008 Aug;86(2):614-21 - PubMed

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