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Ann Thorac Surg 1997;63:603
© 1997 The Society of Thoracic Surgeons

Correspondence

Urokinase-Coated Flat Drain for Pediatric Cardiac Operations

Yuzuru Sakakibara, MD, Naotaka Atsumi, MD, Masakazu Abe, MD, Toshio Mitsui, MD

Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Science City, Ibaraki, 305, Japan

To the Editor:

Silicone rubber and polyvinyl chloride tubes are currently used for pericardial and retrosternal drains after pediatric cardiac operations. These tubes are often obstructed by blood clots and deposits of fibrin. The cross-sectional area of the pediatric drains should be reduced in size, although drainage must be kept as efficient as in the drain for adults. A urokinase coating on the inner surface of the polyvinyl chloride tube has been introduced into clinical use [1], although it is not widely used for pediatric cardiac operations. For pediatric use, we have developed a small-diameter urokinase-coated flat drain, which has an oval cross-section (diameters of 4 mm and 6 mm). These drains were tested in 21 pediatric patients who had undergone cardiac operations, and clinical applicability was demonstrated. During application, the patency of the drains was carefully observed. The duration of drainage was 2.8 ± 0.7 days (mean ± standard deviation), and the total amount of discharge through these drains was 112 ± 84 mL. Residual urokinase activity on the inner surface of the tube was 35.6% ± 17.6% [2].

There was no occlusion of these drains, and consumption of urokinase on the inner surface was confirmed in this study. The application of urokinase to a soft and flexible flat drain may have the advantages of excellent postoperative drainage and antiarrhythmogenicity, especially in neonates and small infants. This drain shows strong potential for helping in the management of patients after pediatric cardiac operations.

References

  1. Yabushita Y. Studies on the properties of immobilized urokinase. Effects of pH and temperature. Biotechnol Appl Biochem 1988;10:294–300.[Medline]
  2. Morita T, Kato H, Iwanaga S, et al. New fluorogenic substrates for alpha-thrombin, factor Xa, kallikreins and urokinase. J Biochem Tokyo 1977;82:I495–8.




This Article
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