Experience with the polytetrafluoroethylene surgical membrane for pericardial closure in operations for congenital cardiac defects

Amato, Joseph J.; Cotroneo, Joseph V.; Galdieri, R; Alboliras, Ernerio T.; Antillon, Jose R.; Vogel, Robert L.

doi:10.1016/s0022-5223(19)34498-8

Cited by 34 publications

(8 citation statements)

References 23 publications

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“…Nesses trabalhos, não há referências a reoperações. Com relação aos inabsorvíveis, a membrana cirúrgica de politetrafluoretileno (PTFE) é a que tem apresentado comportamento mais satisfatório (20,26,27,32) . Contudo, MEUS et al (25) observaram, no cão, que a membrana de PTFE provoca intensa reação epicárdica que impede o reconhecimento dos vasos coronários subjacentes.…”

Section: Comentáriosunclassified

“…Esses são os motivos pelos quais tem-se buscado maneiras de se fechar a cavidade pericárdica com técnicas diversas de pericardioplastia (10)(11)(12) e com substitutos do pericárdio, biológicos e sintéticos. Os primeiros podem ser autólogos (7,13,14) ou heterólogos (15)(16)(17)(18)(19)(20)(21) , os últimos, inabsorvíveis (22)(23)(24)(25)(26)(27) e absorvíveis (27)(28)(29)(30) .…”

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Substituição parcial do pericárdio de cães por membrana de látex natural

Sader¹,

Netto²,

Neto³

et al. 2000

Rev Bras Cir Cardiovasc

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Section: Comentáriosunclassified

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Substituição parcial do pericárdio de cães por membrana de látex natural

Sader¹,

Netto²,

Neto³

et al. 2000

Rev Bras Cir Cardiovasc

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“…The ePTFE membrane is the most widely utilized synthetic surgical membrane for pericardial closure when native pericardium is unavailable. Previous studies have shown that it has non-adhesive qualities and allows resternotomies to be performed [ 15 , 16 ]. Despite these favorable reports, the routine application of ePTFE for pericardial closure has been called into question because some potentially crucial disadvantages have been identified.…”

Section: Discussionmentioning

confidence: 99%

Surgical Results of Third or More Cardiac Valve Operation

Sohn

Hwang

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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BackgroundWe evaluated operative outcomes after third or more cardiac operations for valvular heart disease, and analyzed whether pericardial coverage with artificial membrane is helpful for subsequent reoperation.MethodsFrom 2000 to 2012, 149 patients (male: female=70: 79; mean age at operation, 57.0±11.3 years) underwent their third to fifth operations for valvular heart disease. Early results were compared between patients who underwent their third operation (n=114) and those who underwent fourth or fifth operation (n=35). Outcomes were also compared between 71 patients who had their pericardium open during the previous operation and 27 patients who had artificial membrane coverage.ResultsIntraoperative adverse events occurred in 22 patients (14.8%). Right atrium (n=6) and innominate vein (n=5) were most frequently injured. In-hospital mortality rate was 9.4%. Total cardiopulmonary bypass time (225±77 minutes vs. 287±134 minutes, p=0.012) and the time required to prepare aortic cross clamp (209±57 minutes vs. 259±68 minutes, p<0.001) increased as reoperations were repeated. However, intraoperative event rate (13.2% vs. 20.0%), in-hospital mortality (9.6% vs. 8.6%) and postoperative complications were not statistically different according to the number of previous operations. Pericardial closure using artificial membrane at previous operation was not beneficial in reducing intraoperative events (25.9% vs. 18.3%) and shortening operation time preparing aortic cross clamp (248±64 minutes vs. 225±59 minutes) as compared to no-closure.ConclusionClinical outcomes of the third or more operations for valvular heart disease were acceptable in terms of intraoperative adverse events and in-hospital mortality rates. There were no differences in the incidence of intraoperative adverse events, early mortality and postoperative complications between third cardiac operation and fourth or more.

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“…Several cases had associated failure to reduce adhesion and the membrane can interfere with postoperative transthoracic echocardiography. 7 While PTFE membranes have been used in mostly congenital heart surgery, Minale et al5,21 reported experience with PTFE in adults thought to be at high risk for reoperation. There were no postoperative complications related to the PTFE.…”

Section: Discussionmentioning

confidence: 99%

Protection of the Internal Mammary Artery Pedicle with Polytetrafluoroethylene Membrane

Zehr¹,

Lee²,

Poston³

et al. 1993

J Cardiac Surgery

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With increasing frequency, reoperative coronary artery bypass surgery is being performed in the setting of a patent internal mammary artery (IMA) graft. Injury to the IMA graft at reoperation can result in ischemic myocardial injury and cardiac arrest. This descriptive laboratory study examined use of a polytetrafluoroethylene (PTFE) membrane wrap to protect the IMA pedicle during sternal reentry. Six pigs (25-30 kg) underwent median sternotomy and takedown of left and right IMAs. Grafts were implanted in the epicardium by a modified Vineberg procedure. In each animal, one IMA was wrapped circumferentially with PTFE, while the contralateral bare IMA served as the control. Redo sternotomy was performed 3 months later. Severe adhesions between chest wall, myocardium, and bare IMA grafts were encountered in six of six animals. PTFE-wrapped IMAs were easily identified by appearance and by palpation. There was no adherence between PTFE membranes and surrounding tissue, nor was there evidence of cellular infiltration, disruption, or contraction of the membrane. Most notably, PTFE membranes could not be cut or injured with the electrocautery, since they are electrical nonconductors. This study demonstrates that PTFE membrane: (1) is relatively inert and incites minimal surrounding tissue reaction; and (2) is impenetrable to electrocautery injury. Further studies are necessary to determine the impact of PTFE membrane on IMA graft patency and wound infection. PTFE membrane may prove clinically useful in protecting patent IMA pedicles during reoperative cardiac surgery.

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Experience with the polytetrafluoroethylene surgical membrane for pericardial closure in operations for congenital cardiac defects

Cited by 34 publications

References 23 publications

Substituição parcial do pericárdio de cães por membrana de látex natural

Substituição parcial do pericárdio de cães por membrana de látex natural

Surgical Results of Third or More Cardiac Valve Operation

Protection of the Internal Mammary Artery Pedicle with Polytetrafluoroethylene Membrane

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