Experience with Expanded Polytetrafluoroethylene (ePTFE Gore‐Tex) Surgical Membrane for Coronary Artery Grafting: Does ePTFE Surgical Membrane Predispose to Postoperative Mediastinitis?

Abstract

The advantage of completely closing the pericardium after a coronary artery bypass grafting is the avoidance of injury of the heart and grafts during a re-operation. However, it would obviously be counterproductive to close the pericardium with a substitute that is predisposed to infection. This study was designed to evaluate the safety of ePTFE surgical membrane in comparison to native pericardium or autologous tissue. Between January 1992 to March 2003, 695 coronary artery bypass graftings were performed. The hearts and grafts were covered with ePTFE surgical membrane (474 cases: ePTFE group), or autologous pericardium and/or other autologous tissue (221 cases: non-ePTFE group). Often, a bilateral dissection of the internal thoracic artery was performed, which lengthened the surgery, the cardiopulmonary bypass, and the aortic clamp, in the ePTFE group. But there was no difference between the ePTFE group (2.1%) and the non-ePTFE group (3.2%) in the development of postoperative mediastinitis. There was also no difference between the two groups in the organism type of the infection. Methicillin resistant Staphylococcus aureus (MRSA) is the most common organism cultured from sternal wound infections; there were five cases in the ePTFE group, and four cases in the non-ePTFE group. In the ePTFE group, the hospital mortality due to postoperative mediastinitis was zero, and there was also no significant difference between the ePTFE group and the non-ePTFE group in time from the drainage operation to discharge; 74.3 days in the ePTFE group, and 81.0 days in the non-ePTFE group. The clinical use of ePTFE surgical membrane for a coronary artery bypass grafting does not appear to be a risk factor for mediastinitis.

Controlled Delivery of Basic Fibroblast Growth Factor Promotes Human Cardiosphere-Derived Cell Engraftment to Enhance Cardiac Repair for Chronic Myocardial Infarction

“…The gelatin was isolated by an alkaline process from bovine bone with an isoelectric point of 5.0 as previously described (10). The water content of gelatin hydrogel was prepared to 94% by chemical cross-linking at 140°C for 72 h. The gelatin was reinforced by polytetrafluoroethylene (W. L. Gore and Associates, Inc., Flagstaff, Arizona) pericardial sheet (12) to provide strength against the beating heart. Human recombinant bFGF (Kaken Pharmaceutical Co., Tokyo, Japan) was incorporated into the gelatin hydrogel by impregnation for 3 h before implantation.…”

Omniphobic “RF Paper” Produced by Silanization of Paper with Fluoroalkyltrichlorosilanes

“…To channel or restrict the flow of liquids requires non‐permeable materials; to transport gases requires porous media. Porous, water‐repellent materials based on expanded polytetrafluoroethylene (ePTFE, Gore‐Tex, Nafion, Teflon) and other polymers have been useful in a wide range of applications, from high performance fabrics and membrane filters to fuel cells, surgical implants, and lung‐assist devices . The relatively high cost (from ∼USD$1500 m ‐2 for Nafion to ∼$29 m ‐2 for Gore‐Tex) of these materials has, however, limited their utilization for applications requiring a low‐cost or single‐use format.…”

Suspected involvement of EPTFE membrane in sterile intrathoracic abscess and pericardial empyema in a multi-allergic LVAD recipient: a case report

“…Permanent presence in the mediastinum of non-resorbable foreign material additionally poses questions with regard to its implications in terms of infection. However, over the past two decades, different studies concluded that ePTFE membrane can safely be used in cardiac surgery to limit adhesions without increasing the risk of infection [ 27 – 30 ].…”