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Ann Thorac Surg 2003;76:1270-1274
© 2003 The Society of Thoracic Surgeons

New technology

Reducing the incidence and severity of pericardial adhesions with a sprayable polymeric matrix

Wolfgang F. Konertz, MD, PhDa, Martin Kostelka, MD, PhDb, Friedrich W. Mohr, MD, PhDc, Roland Hetzer, MD, PhDc, Michael Hübler, MDc, Julia Ritter, MDa, Jianchi Liu, MDa, Christina Koch, MDa, Jon E. Block, PhDd*

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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