Expanded PTFE Membrane to Prevent Cardiac Injury During Resternotomy for Congenital Heart Disease

Jacobs, Jeffrey P.; Iyer, Raju S; Weston, Jo S; Amato, Joseph J.; Elliott, Martin J.; Leval, Marc R. de; Stark, Jaroslav

doi:10.1016/s0003-4975(96)00610-8

Cited by 70 publications

(53 citation statements)

References 20 publications

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“…No clinical experience with any of these agents has been reported. Expanded polytetrafluoroethylene, a biocompatible material, has been used safely and effectively for many years in multiple clinical applications in several surgical areas, including vascular surgery [19,22,27], soft-tissue repair [3], plastic surgery [23], gynaecology [5], cardiac surgery [14] and neurosurgery [13,33]. In long-term follow-up on patients in whom an ePTFE membrane [3,10,27,33] was implanted, the presence of wear debris was not shown; similarly, the implantation of this membrane in the defect of a rachidial laminectomy is not submitted to the same shear forces that prosthetic articular implants are.…”

Section: Discussionmentioning

confidence: 99%

“…In a randomized clinical trial, ePTFE membranes reduced postmyomectomy adhesion formation [24]. Jacobs et al [14] implanted ePTFE membrane pericardial substitutes in 1,085 patients with congenital heart disease to prevent cardiac injury at reoperation. They reoperated on 105 of those patients and found no problematic adhesions between the membrane and the heart or the membrane and the chest wall.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

Llado¹,

Sologaistua²,

Guimerà³

et al. 1999

European Spine Journal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

Llado¹,

Sologaistua²,

Guimerà³

et al. 1999

European Spine Journal

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“…However, routine use autogenous pericardium in various congenital cardiac operations and the risk of hemodynamic compromise induced the search for other substitutes. Expanded PTFE has been demonstrated being safe and effective in preventing pericardial adhesions in a retrospective observational study by Jacobs et al [23] In this multicenter study including 1,085 operations of congenital heart defects, 105 of which were reoperated, injury during resternotomy occurred in one patient only (1%). However, in a more recent animal study by Kuschel et al, [24] no significant difference of pericardial adhesions was found between the group left uncovered (control) and the group where the pericardial defect was repaired with ePTFE membrane.…”

Section: Discussionmentioning

confidence: 88%

Combined use of barrier methods to prevent pericardial adhesions: Is it always better?

Korun¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada bir tavşan modeli üzerinde perikard kapatılması, genişletilmiş politetrafloroetilen (ePTFE) membran ve rezorbe edilebilen adezyon bariyerinin (REPEL-CV ® ) kombine ya da ayrı ayrı kullanımının perikardiyal adezyonlar üzerine etkileri araştırıldı.Ça lış mapla nı:Otuz tavşan altı gruba randomize edildi: kontrol, perikard, genişletilmiş politetrafloroetilen, rezorbe edilebilen membran, genişletilmiş politetrafloroetilen + rezorbe edilebilen membran ve perikard + rezorbe edilebilen membran. Ameliyat sonrası beşinci haftada yapışıklıkların yoğunluğu kalitatif bir derecelendirme sistemi kullanılarak değerlendirildi ve histolojik örnekler incelendi. Bul gu lar:Rezorbe edilebilen membran grubunun tenasite skorları kontrol, perikard ve genişletilmiş politetrafloroetilen gruplarına kıyasla, anlamlı düzeyde düşük bulundu (p<0.01). Genişletilmiş politetrafloroetilen + rezorbe edilebilen membran ve perikard + rezorbe edilebilen membran gruplarının skorları, kontrol grubuna kıyasla, daha düşük bulundu (sırasıyla p<0.05 ve p<0.01). Rezorbe edilebilen membranın kombine kullanımında, tek başına kullanımına kıyasla, skorlarda anlamlı farklılık saptanmadı. Makroskopik olarak rezorbe edilebilen membran grubunda sternotomi sonrası perikard üzerinde parmak ile kolayca diseke edilebilir ince yapışıklıklar vardı. Genişletilmiş politetrafloroetilen + rezorbe edilebilen membran ve perikard + rezorbe edilebilen membran gruplarında sternum altında da yapışıklıklar izlendi.So nuç:Rezorbe edilebilen membran tek başına ya da genişletilmiş politetrafloroetilen membran veya perikard kapatılması ile kombine olarak kullanıldığında, perikardiyal adezyonları azaltmada etkiliydi. Genişletilmiş politetrafloroetilen membran ve perikardium kapanması substernal fibrozisi artırdığından, rezorbe edilebilen membranın kombine kullanımından ziyade tek başına kullanımı tercih edilebilir.Anah tar söz cük ler: Biyouyumlu malzemeler; tekrar ameliyat; cerrahi adezyonlar. ABSTRACTBackground: This study aims to investigate the effects of combined and individual use of pericardial closure, expanded polytetrafluoroethylene membrane and resorbable adhesion barrier (REPEL-CV

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“…The rationale for their use was the interposition of an effective barrier which prevents the development of tight adherences between the dura mater and the dense fibrotic scar originated at the inner surface of the paravertebral musculature 34 . Expanded Gore-Tex has been used effectively and safely for multiple clinical applications in several surgical areas, including cardiac surgery 18 , vascular surgery 26 , plastic surgery 29 , soft-tissue repair 4 , gynaecology 6 , and neurosurgery 17,36 . Gore-Tex membranes have been used [360][361][362][363][364][365][366] in spine surgery with a function as a barrier to minimize adhesions in several parts of the body.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Oxiplex and Gore-Tex effectivity in an experimental peridural fibrosis model

et al. 2009

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SummaryObjective. The authors conducted a study to compare the effectiveness of Oxiplex and Gore-tex in preventing postlaminectomy peridural fibrosis in rats. Peridural fibrosis is a common cause of pain in patients undergoing spinal surgery. To prevent scar formation numerous materials and methods have been employed such as non steroidal anti-inflammatory drugs (NSAIDs), Gelfoam, Oxiplex, Gore-tex, carboxymethil cellulose, Adcon-L, autogenous adipose grefting, mitomisin, and radiotherapy have been investigating for a long time, but only moderate success has been obtained.Methods. Laminectomies were performed at the fourth lumbar vertebra (L-4) in 30 rats. Oxiplex or Gore-Tex was applied over the dura mater with the aim to perform a blinded evaluation of their effects. In the control group, only a L-4 laminectomy was performed. Animals were sacrificed 28 days after the surgical procedure. The extent of peridural fibrosis was evaluated on spine specimens by histological analysis.Results. Both groups of animals treated with either Oxiplex or Gore-Tex showed a significant reduction in the degree of peridural fibrosis as compared to the control group. However no significant difference in the prevention of peridural fibrosis was observed between the Oxiplex and Gore-Tex groups.Conclusions. This experimental model has shown that Oxiplex and Gore-Tex are effective methods to prevent peridural fibrosis and dural adhesions at the postlaminectomy areas.KEY WORDS: Peridural fibrosis. Oxiplex. Gore-Tex. Failed back syndrome.Comparación entre la eficacia del Oxiplex y del GoreTex en un modelo experimental de fibrosis peridural ResumenObjetivo. Los autores realizaron un estudio para comparar la eficacia de Oxiplex y Gore-tex en la prevención de fibrosis peridural tras laminectomías en ratas. La fibrosis peridural es una causa común de dolor en pacientes sometidos a cirugía de la columna vertebral. Para evitar la formación de cicatriz, se han empleado numerosos materiales y métodos como los antiinflamatorios no esteroideos (AINE), Gelfoam, Oxiplex, Gore-tex, carboxymethil celulosa, Adcon-L, injertos de grasa antóloga, mitomicina o la radioterapia, pero sólo se ha obtenido resultados exitosos en pocas ocasiones.Métodos. Se realizaron laminectomías en la cuarta vértebra lumbar (L-4) en 30 ratas. Se aplicaron Oxiplex o Gore-Tex sobre la duramadre con el objetivo de realizar una evaluación ciega de sus efectos. En el grupo control, sólo se realizó la laminectomía L4. Los animales fueron sacrificados 28 días después de la intervención quirúrgica. El grado de fibrosis peridural se evaluó sobre la columna vertebral de especímenes por análisis histológico.Resultados. Ambos grupos de animales tratados con Oxiplex o Gore-Tex mostraron una reducción significativa en el grado de fibrosis peridural en comparación con el grupo control. Sin embargo, ninguna diferencia significativa en la prevención de la fibrosis peridural se observó entre los grupos de Oxiplex y Gore-Tex.Conclusiones. Este modelo experimental ha demostrado que Oxiplex y Gor...

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Expanded PTFE Membrane to Prevent Cardiac Injury During Resternotomy for Congenital Heart Disease

Cited by 70 publications

References 20 publications

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

Combined use of barrier methods to prevent pericardial adhesions: Is it always better?

Comparison of Oxiplex and Gore-Tex effectivity in an experimental peridural fibrosis model

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