Pericardial closure

The use of ECM-derived materials in cardiovascular surgery falls into four broad categories bioprosthetic heart valves, septal defects closure, coronary and peripheral vascular repair, and pericardial closure. Each represents a unique application with significantly different anatomic and physiologic requirements. Several of these are treated in depth by others in this volume or elsewhere. " Of these, pericardial closure is perhaps the most often overlooked procedure and the one I ve elected to review here. 

Pericardium from a variety of sources has been used in pericardial closure. In 1984, Yakirevish et al. published the results of a 66 patient series spanning a period from 1977 to 1983. In all cases, glutaraldehyde crosslinked bovine pericardium was used. The authors reported that all of the patients did well postop-eratively and in the three patients who required reoperation at 2.5, 3, and 7 years, the bovine pericardial patch appeared to have prevented epicardial adhesions and... 

Merav AD, Brodman R, Altai LA, Robinson C. A simple technique for tension-free pericardial closure. Ann Thorac Surg 1979 28(4) 399 00. 

Kargar F, Aaxami MH. Rotational pericardial flap an alternative tension-free technique for pericardial closure. J Thorac Cardovasc Surg 2007 134(2) 510-1. 

Zaplanski A, Fishman NH, Bronstein MN, Ellertson DG, O ConneUTJ, Siegel S. Modified pericardial closure to protect cardiovascular structures during sternal reentry. Ann Thorac Surg 1990 50(4) 665-6. 

Boyd WD, Tyberg IV, Cox JL. A review of the cnrrent status of pericardial closure following cardiac surgery. Expert Rev Cardiovasc 77i r 2012 10(9) 1109—18. 

Eng J, Ravishandran PS, Abbott CR, Kay PH, Murday AJ, Shreiti I. Reoperation after pericardial closure with bovine pericardium. Arm Thorac Surg 1989 48(6) 813-5. 

Pericardial ablation procedure Left auricular closure device... 

Malm, T Bowald, S. Bylock, A. and Busch, C. Prevention of postoperative pericardial adhesions by closure of the pericardium with absorbable polymer patches. An experimental study. J. Thoracic Cardiovascular Surg. 1992,104, 600-607(c). 

Singh T, Ross D, Thomson D. Closure of pericardium using pericardial fat in primary cardiac operations. Internet J Thorac Cardiovasc Surg 2007 12(2) 9843. 

Gallo II, Pomar JL, Artiriano E, Val F, Duran CMG. Heterologous pericardium for the closure of pericardial defects. Ann Thorac Surg 1978 26(2) 149-54. 

P3HB patches have shown potential for guided tissue regeneration in a number of animal studies and in patients. Nonwoven P3HB patches made from solution-spun fibers have been extensively studied for defect repair in heart surgery, such as for pericardial substitution [32,33,142,143,204,211-213], for closure of atrial septal defects [144], and for enlargement of the right ventricular outflow tract and the pulmonary artery [145]. 

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