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Ann Thorac Surg 2003;76:1270-1274
© 2003 The Society of Thoracic Surgeons
a University Hospital for Cardiovascular Surgery, Berlin (Charité), Germany
b University Hospital Heart Center, Leipzig, Germany
c German Heart Institute, Berlin, Germany
d German Heart Institute, San Francisco, California, USA
Accepted for publication April 23, 2003.
* Address reprint requests to Dr Block, 2210 Jackson St, Suite 401, San Francisco, CA 94115, USA
e-mail: jonblock{at}sbcglobal.net
Abstract
PURPOSE: This study was undertaken to evaluate the antiadhesive properties of a polymeric agent in infants undergoing staged surgical correction of congenital heart abnormalities.
DESCRIPTION: Sixteen infants having staged surgical repair were treated with a polymeric matrix at the completion of the initial surgery. There were 5 untreated controls. The tenacity and extent of adhesions at five separate regions of the heart were evaluated at the follow-up surgery.
EVALUATION: For all sites combined, there was a threefold difference in median tenacity scores in favor of the experimental treatment (1.0 vs 3.0, p < 0.01). Significant differences were achieved separately at the right ventricle and the anterior surface of the great vessels (p = 0.02 for both comparisons). Analysis of adhesion scores reflecting the extent of adhesions similarly favored the experimental treatment for all sites (80 vs 270, p < 0.01), with significant differences persisting at the right atrium (p < 0.01) and the anterior surface of the great vessels (p = 0.04). There were no treatment-related adverse events.
CONCLUSIONS: Use of this polymeric agent at the completion of open cardiac surgery may prevent the occurrence or reduce the severity of pericardial adhesions.
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