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Pfeifer J, Rentzsch A, Poryo M, Abdul-Khaliq H. Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle. J Cardiovasc Dev Dis 2024; 11:156. [PMID: 38786978 PMCID: PMC11122585 DOI: 10.3390/jcdd11050156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
Congenital critical aortic valve stenosis (CAVS) is a life-threatening disease requiring urgent treatment. First-line therapy is still controversial. The aim of our study was (1) to analyze retrospectively the patients of our institution who underwent balloon aortic valvuloplasty (BAV) due to CAVS and (2) describe the techniques for improved feasibility of intervention using microcatheters and retrieval loops. Twelve patients underwent 23 BAVs: 1 BAV was performed in 3 patients, 2 BAVs were performed in 7 patients, and 3 BAVs were performed in 2 patients. The peak trans-valvular pressure gradient (Δp) and left ventricular shortening fraction (LVSF) improved significantly in the first two interventions. In the first BAV, Δp decreased from 73.7 ± 34.5 mmHg to 39.8 ± 11.9 mmHg (p = 0.003), and the LVSF improved from 22.3 ± 13.5% to 31.6 ± 10.2% (p = 0.001). In the second BAV, Δp decreased from 73.2 ± 33.3 mmHg to 35.0 ± 20.2 mmHg (p < 0.001), and the LVSF increased from 26.7 ± 9.6% to 33.3 ± 7.4% (p = 0.004). Cardiac surgery during the neonatal period was avoided for all children. The median time to valve surgery was 5.75 years. Few complications occurred, namely mild-to-moderate aortic regurgitation, one remediable air embolism, and one intimal injury to the ascending aorta. We conclude that BAV is a successful emergency treatment for CAVS, resulting in left ventricular relief, clinical stabilization, and a time gain until cardiac surgery.
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Affiliation(s)
- Jochen Pfeifer
- Department of Pediatric Cardiology, Saarland University Medical Center, 66421 Homburg, Germany
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2
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Feng L, Wang L, Ma Y, Duan W, Martin-Saldaña S, Zhu Y, Zhang X, Zhu B, Li C, Hu S, Bao M, Wang T, Zhu Y, Yang F, Bu Y. Engineering self-healing adhesive hydrogels with antioxidant properties for intrauterine adhesion prevention. Bioact Mater 2023; 27:82-97. [PMID: 37006827 PMCID: PMC10063385 DOI: 10.1016/j.bioactmat.2023.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/08/2023] [Accepted: 03/19/2023] [Indexed: 03/31/2023] Open
Abstract
Intrauterine adhesion (IUA) is the fibrosis within the uterine cavity. It is the second most common cause of female infertility, significantly affecting women's physical and mental health. Current treatment strategies fail to provide a satisfactory therapeutic outcome for IUA patients, leaving an enormous challenge for reproductive science. A self-healing adhesive hydrogel with antioxidant properties will be highly helpful in IUA prevention. In this work, we prepare a series of self-healing hydrogels (P10G15, P10G20, and P10G25) with antioxidant and adhesive properties. Those hydrogels exhibit good self-healing properties and can adapt themselves to different structures. They possess good injectability and fit the shape of the human uterus. Moreover, the hydrogels exhibit good tissue adhesiveness, which is desirable for stable retention and therapeutic efficacy. The in vitro experiments using P10G20 show that the adhesive effectively scavenges ABTS+, DPPH, and hydroxyl radicals, rescuing cells from oxidative stress. In addition, P10G20 offers good hemocompatibility and in vitro and in vivo biocompatibility. Furthermore, P10G20 lowers down the in vivo oxidative stress and prevents IUA with less fibrotic tissue and better endometrial regeneration in the animal model. It can effectively downregulate fibrosis-related transforming growth factor beta 1 (TGF-β1) and vascular endothelial growth factor (VEGF). Altogether, these adhesives may be a good alternative for the clinical treatment of intrauterine adhesion.
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Affiliation(s)
- Luyao Feng
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Liqun Wang
- Department of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Yao Ma
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wanglin Duan
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Sergio Martin-Saldaña
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel de Lardizabal 3, 20018, Donostia-San Sebastián, Spain
| | - Ye Zhu
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xianpeng Zhang
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Bin Zhu
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Chaowei Li
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Shibo Hu
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Mingjie Bao
- JXHC Key Laboratory of Fertility Preservation, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Ting Wang
- JXHC Key Laboratory of Fertility Preservation, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
| | - Yuan Zhu
- Department of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
- JXHC Key Laboratory of Fertility Preservation, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China
- Corresponding author. Department of Reproductive Health, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, China.
| | - Fei Yang
- School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics & Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- Corresponding author. School of Chemical Sciences, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yazhong Bu
- Institute of Medical Engineering, Department of Biophysics, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
- Corresponding author.
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3
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An KR, Christakis N, Jegatheeswaran A, Cusimano RJ, Rao V, Badiwala M, Yau TM. Outcomes of expanded polytetrafluoroethylene pericardial membrane implantation in left ventricular assist device explantation and heart transplantation. J Card Surg 2022; 37:4316-4323. [PMID: 36135788 DOI: 10.1111/jocs.16956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/13/2022] [Accepted: 08/24/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Redo sternotomy and explantation of left ventricular assist devices (LVAD) for heart transplantation (HT) involve prolonged dissection, potential injury to mediastinal structures and/or bleeding. Our study compared a complete expanded polytetrafluoroethylene (ePTFE) wrap versus minimal or no ePTFE during LVAD implantation, on outcomes of subsequent HT. METHODS Between July 2005 and July 2018, 84 patients underwent a LVAD implant and later underwent HT. Thirty patients received a complete ePTFE wrap during LVAD implantation (Group 1), and 54 patients received either a sheet of ePTFE placed in the anterior mediastinum or no ePTFE (Group 2). RESULTS Baseline characteristics were similar between Groups 1 and 2. Surgeons reported subjective improvements in speed, predictability, and safety of dissection with complete ePTFE compared with minimal or no ePTFE. Time from incision to initiation of cardiopulmonary bypass (CPB) were similar between groups (97 ± 38 vs. 89 ± 29 min, p = .3). Injury to mediastinal structures during the dissection was similar between groups (10% vs. 11%, p > .9). While surgeons reported less intraoperative bleeding in Group 1 (43% vs. 61%), this trend did not reach significance (p = .1). In-hospital mortality, intensive care unit length of stay and hospital length of stay were similar between both groups. CONCLUSIONS In patients undergoing LVAD explant-HT, there was a trend toward reduced surgeon reported intraoperative bleeding with ePTFE placement. Despite qualitatively reported greater ease and speed of mediastinal dissection with ePTFE membrane placement, time to initiation of CPB did not differ, likely because surgeons remained cautious, allowing extra time for unanticipated difficulties.
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Affiliation(s)
- Kevin R An
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Christakis
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Anusha Jegatheeswaran
- Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada.,Division of Cardiac Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Robert J Cusimano
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vivek Rao
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Mitesh Badiwala
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Terrence M Yau
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto, Ontario, Canada.,Division of Cardiovascular Surgery, University of Toronto, Toronto, Ontario, Canada
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4
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Head WT, Paladugu N, Kwon JH, Gerry B, Hill MA, Brennan EA, Kavarana MN, Rajab TK. Adhesion barriers in cardiac surgery: A systematic review of efficacy. J Card Surg 2021; 37:176-185. [PMID: 34661944 DOI: 10.1111/jocs.16062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Postoperative pericardial adhesions have been associated with increased morbidity, mortality, and surgical difficulty. Barriers exist to limit adhesion formation, yet little is known about their use in cardiac surgery. The study presented here provides the first major systematic review of adhesion barriers in cardiac surgery. METHODS Scopus and PubMed were assessed on November 20, 2020. Inclusion criteria were clinical studies on human subjects, and exclusion criteria were studies not published in English and case reports. Risk of bias was evaluated with the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with Excel and GraphPad Prism 5. RESULTS Twenty-five studies were identified with a total of 13 barriers and 2928 patients. Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier (13 studies, 67% of patients) with adhesion formation rate of 37.31% and standardized tenacity score of 26.50. Several barriers had improved efficacy. In particular, Cova CARD had a standardized tenacity score of 15.00. CONCLUSIONS Overall, the data varied considerably in terms of study design and reporting bias. The amount of data was also limited for the non-PTFE studies. PTFE has historically been effective in preventing adhesions. More recent barriers may be superior, yet the current data is nonconfirmatory. No ideal adhesion barrier currently exists, and future barriers must focus on the requirements unique to operating in and around the heart.
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Affiliation(s)
- William T Head
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Namrata Paladugu
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jennie H Kwon
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brielle Gerry
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Morgan A Hill
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Emily A Brennan
- Department of Research & Education Services (Libraries), Medical University of South Carolina, Charleston, South Carolina, USA
| | - Minoo N Kavarana
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Taufiek K Rajab
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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5
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Fujita M, Policastro GM, Burdick A, Lam HT, Ungerleider JL, Braden RL, Huang D, Osborn KG, Omens JH, Madani MM, Christman KL. Preventing post-surgical cardiac adhesions with a catechol-functionalized oxime hydrogel. Nat Commun 2021; 12:3764. [PMID: 34145265 PMCID: PMC8213776 DOI: 10.1038/s41467-021-24104-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/02/2021] [Indexed: 11/12/2022] Open
Abstract
Post-surgical cardiac adhesions represent a significant problem during routine cardiothoracic procedures. This fibrous tissue can impair heart function and inhibit surgical access in reoperation procedures. Here, we propose a hydrogel barrier composed of oxime crosslinked poly(ethylene glycol) (PEG) with the inclusion of a catechol (Cat) group to improve retention on the heart for pericardial adhesion prevention. This three component system is comprised of aldehyde (Ald), aminooxy (AO), and Cat functionalized PEG mixed to form the final gel (Ald-AO-Cat). Ald-AO-Cat has favorable mechanical properties, degradation kinetics, and minimal swelling, as well as superior tissue retention compared to an initial Ald-AO gel formulation. We show that the material is cytocompatible, resists cell adhesion, and led to a reduction in the severity of adhesions in an in vivo rat model. We further show feasibility in a pilot porcine study. The Ald-AO-Cat hydrogel barrier may therefore serve as a promising solution for preventing post-surgical cardiac adhesions.
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Affiliation(s)
- Masaki Fujita
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Gina M Policastro
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Austin Burdick
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Hillary T Lam
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Jessica L Ungerleider
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Rebecca L Braden
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA
| | - Diane Huang
- Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Kent G Osborn
- Division of Comparative Pathology and Medicine, School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Jeffrey H Omens
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA
- Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Michael M Madani
- Division of Cardiovascular and Thoracic Surgery, University of California, San Diego, San Diego, CA, USA
| | - Karen L Christman
- Department of Bioengineering, University of California, San Diego, San Diego, CA, USA.
- Sanford Consortium for Regenerative Medicine, University of California, San Diego, San Diego, CA, USA.
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6
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Capella-Monsonís H, Kearns S, Kelly J, Zeugolis DI. Battling adhesions: from understanding to prevention. BMC Biomed Eng 2019; 1:5. [PMID: 32903353 PMCID: PMC7412649 DOI: 10.1186/s42490-019-0005-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 01/20/2019] [Indexed: 12/28/2022] Open
Abstract
Adhesions represent a major burden in clinical practice, particularly following abdominal, intrauterine, pericardial and tendon surgical procedures. Adhesions are initiated by a disruption in the epithelial or mesothelial layer of tissue, which leads to fibrin adhesion sites due to the downregulation of fibrinolytic activity and an increase in fibrin deposition. Hence, the metabolic events involved in tissue healing, coagulation, inflammation, fibrinolysis and angiogenesis play a pivotal role in adhesion formation. Understanding these events, their interactions and their influence on the development of post-surgical adhesion is crucial for the development of effective therapies to prevent them. Mechanical barriers, antiadhesive agents and combination thereof are customarily used in the battle against adhesions. Although these systems seem to be effective at reducing adhesions in clinical procedures, their prevention remains still elusive, imposing the need for new antiadhesive strategies.
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Affiliation(s)
- Héctor Capella-Monsonís
- Regenerative, Modular and Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
- Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | | | - Jack Kelly
- University Hospital Galway, Galway, Ireland
| | - Dimitrios I. Zeugolis
- Regenerative, Modular and Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
- Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
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7
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Funamoto S, Hashimoto Y, Kishida A, Negishi J. A fibrin-coated pericardial extracellular matrix prevented heart adhesion in a rat model. J Biomed Mater Res B Appl Biomater 2018; 107:1088-1094. [PMID: 30230682 DOI: 10.1002/jbm.b.34201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/21/2018] [Accepted: 06/27/2018] [Indexed: 01/17/2023]
Abstract
As most surgical treatments pose a risk of tissue adhesion, methods to prevent adhesion are needed across various surgical fields. In this study, we investigated the use of a decellularized pericardium with fibrin glue to prevent rat heart adhesion. Porcine pericardia were decellularized by a high-hydrostatic pressure method. Cells adhered to the resulting pericardial extracellular matrix (ECM) during an in vitro cell-seeding test, but fibrin-coated pericardial ECM showed reduced cell adhesion. In a rat surgical model of heart adhesion, the fibrin-coated pericardial ECM did not adhere to the heart and mesothelial cell adhesion was observed on the ECM surface. Notably, the anti-adhesion effect of fibrin-coated pericardial ECM was observed 4 weeks after surgery. These results support the utility of fibrin-coated pericardial ECM as an adhesion prevention material for cardiovascular surgery. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1088-1094, 2019.
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Affiliation(s)
- Seiichi Funamoto
- Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, 060-8543, Japan.,Department of Material-Based Medical Engineering, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, 101-0023, Japan
| | - Yoshihide Hashimoto
- Department of Material-Based Medical Engineering, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, 101-0023, Japan
| | - Akio Kishida
- Department of Material-Based Medical Engineering, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, 101-0023, Japan
| | - Jun Negishi
- Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, 060-8543, Japan.,Japan Society for the Promotion of Science, Tokyo, 102-8472, Japan.,Faculty of Textile Science and Technology, Shinshu University, Nagano, 386-8567, Japan
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8
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Careaga Reyna G, Zetina Tun HJ, Lezama Urtecho CA, Arellano Juárez L, Alvarez-Sánchez LM. Trasplante de corazón en pacientes con cirugía cardiaca previa. CIRUGIA CARDIOVASCULAR 2017. [DOI: 10.1016/j.circv.2016.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Lefort B, El Arid JM, Bouquiaux AL, Soulé N, Chantreuil J, Tavernier E, Chantepie A, Neville P. Is Seprafilm valuable in infant cardiac redo procedures? J Cardiothorac Surg 2015; 10:47. [PMID: 25880562 PMCID: PMC4383064 DOI: 10.1186/s13019-015-0257-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Morbidity and mortality are higher for cardiac reoperations than first operation due to the presence of post-operative adhesions. We retrospectively evaluated the efficacy of the bioresorbable membrane Seprafilm to prevent pericardial adhesions after cardiac surgery in a paediatric congenital heart disease population. METHODS Seventy-one children undergoing reoperations with sternotomy redo and cardiopulmonary bypass for congenital malformations were included. Twenty-nine of these patients were reoperated after previous application of Seprafilm (treatment group). The duration of dissection, aortic cross clamping and total surgery were recorded. A tenacity score was established for each intervention from the surgeon's description in the operating report. RESULTS In multivariate analysis, the duration of dissection and the tenacity score were lower in the treatment than control group (p < 0.01), independent of age and interval since preceding surgery. CONCLUSION Our results suggest that Seprafilm is effective in reducing the post-operative adhesions associated with infant cardiac surgery. We recommend the use of Seprafilm in paediatric cardiac surgery when staged surgical interventions are necessary.
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Affiliation(s)
- Bruno Lefort
- Children Hospital Gatien de Clocheville, Tours, France. .,University François Rabelais, Tours, France.
| | | | | | | | | | - Elsa Tavernier
- Children Hospital Gatien de Clocheville, Tours, France. .,INSERM, CIC 202, Tours, France.
| | - Alain Chantepie
- Children Hospital Gatien de Clocheville, Tours, France. .,University François Rabelais, Tours, France.
| | - Paul Neville
- Children Hospital Gatien de Clocheville, Tours, France.
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10
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Imran Hamid U, Digney R, Soo L, Leung S, Graham AN. Incidence and outcome of re-entry injury in redo cardiac surgery: benefits of preoperative planning. Eur J Cardiothorac Surg 2014; 47:819-23. [DOI: 10.1093/ejcts/ezu261] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/26/2014] [Indexed: 12/22/2022] Open
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