Anti-inflammatory properties of amniotic membrane patch following pericardiectomy for constrictive pericarditis

Abstract

BackgroundSince constrictive pericarditis is most often idiopathic and the pathophysiology remains largely unknown, both the diagnosis and the treatment can be challenging. However, by definition, inflammatory processes are central to this disease process. Amniotic membrane patches have been shown to possess anti-inflammatory properties and are believed to be immune privileged. Due to these properties, amniotic membrane patches were applied intraoperatively in a complicated patient presenting with constrictive pericarditis.Case presentationA patient with a history of multiple cardiac surgeries presented with marked fatigue, worsening dyspnea and sinus tachycardia. He was found to have constrictive physiology during cardiac catheterization, with cardiac MRI demonstrating hepatic vein dilatation, atrial enlargement and ventricular narrowing. After amniotic membrane patch treatment and pericardiectomy, post-operative cardiac MRI failed to demonstrate any appreciable pericardial effusion or inflammation, with no increased T2 signal that would suggest edema.ConclusionsGiven the positive results seen in this complex patient, we suggest continued research into the beneficial properties of amniotic membrane patches in cardiac surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-017-0567-7) contains supplementary material, which is available to authorized users.

Fifteen-year experience with pericardiectomy at a tertiary referral center

“…In our study, we did not find a notable relationship between extent of resection and recurrence of symptoms. Mitigation of recurrence risk is a realm of ongoing study; novel techniques such as the use of allograft stem cells or amniotic membrane patch during pericardiectomy may show promise in this regard [ 29 ].…”

Human Amniotic Membrane: A review on tissue engineering, application, and storage

“…Native hAM has been applied as a scaffold for TE and regeneration in different medical fields (the reader can find this information in previous sections). Some reviews describe its use as a grafting material, 8 in oral and periodontal surgeries, 23 cartilage damage, 7 lower extremity repair, 121 healing of chronic wounds and ulcers, 122 as a biomaterial in urology, 123,124 in gynecology, 125 as of patch for cardiac surgery, 126 and as a treatment of ocular surface pathologies. 29 In ophthalmology, the transplantation of frozen or fresh hAM is often used for pterygium excision, conjunctival surface reconstruction (e.g., after symblepharon lysis), reepithelialization in corneal ulcer, or for temporary closure of perforated corneas.…”

A pilot trial of human amniotic fluid for the treatment of COVID-19

“…Indeed, human amniotic products have a broad immune mediating profile [5]. Human amniotic membrane (hAM) and human amniotic fluid (hAF) have been shown to reduce inflammation, have antimicrobial properties, and confer a low risk of immunogenicity [6][7][8][9][10][11]. Purified hAF is non-antigenic solution devoid of any cellular products (i.e., it is not to be confused with umbilical cord-derived, AF-derived stem cell products, or AF embolism) that nature developed [5,12].…”