Consequences of PTFE membrane used for prevention of re-entry injuries in rheumatic valve disease

Özeren, Murat; Han, Ünsal; Mavioglu, Ilhan; Simsek, Erdal; Soyal, Tolga; Güler, Gülçin; Yücel, Ertan

doi:10.1016/s0967-2109(02)00061-3

Cited by 17 publications

(10 citation statements)

References 15 publications

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“…In addition, the artificial membrane made the dissection of cardiac structures to apply the aortic cross-clamp more time-consuming, although the difference was not statistically significant. This corroborated previous findings indicating that ePTFE membranes can interfere with the epicardial anatomy [ 17 , 18 ].…”

Section: Discussionsupporting

confidence: 92%

“…Despite these favorable reports, the routine application of ePTFE for pericardial closure has been called into question because some potentially crucial disadvantages have been identified. Both human [ 17 ] and animal [ 18 ] studies have demonstrated that ePTFE may aggravate the normal epicardial reaction, resulting in the deposition of a thick, fibrous, and often hemorrhagic layer that obscures the epicardial anatomy, interfering with safe sternal re-entry and dissection of the intrapericardial space. In the present study, we found that closing the pericardium with ePTFE did not improve the incidence of adverse events compared to leaving the pericardium open.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Results of Third or More Cardiac Valve Operation

Sohn

Hwang

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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BackgroundWe evaluated operative outcomes after third or more cardiac operations for valvular heart disease, and analyzed whether pericardial coverage with artificial membrane is helpful for subsequent reoperation.MethodsFrom 2000 to 2012, 149 patients (male: female=70: 79; mean age at operation, 57.0±11.3 years) underwent their third to fifth operations for valvular heart disease. Early results were compared between patients who underwent their third operation (n=114) and those who underwent fourth or fifth operation (n=35). Outcomes were also compared between 71 patients who had their pericardium open during the previous operation and 27 patients who had artificial membrane coverage.ResultsIntraoperative adverse events occurred in 22 patients (14.8%). Right atrium (n=6) and innominate vein (n=5) were most frequently injured. In-hospital mortality rate was 9.4%. Total cardiopulmonary bypass time (225±77 minutes vs. 287±134 minutes, p=0.012) and the time required to prepare aortic cross clamp (209±57 minutes vs. 259±68 minutes, p<0.001) increased as reoperations were repeated. However, intraoperative event rate (13.2% vs. 20.0%), in-hospital mortality (9.6% vs. 8.6%) and postoperative complications were not statistically different according to the number of previous operations. Pericardial closure using artificial membrane at previous operation was not beneficial in reducing intraoperative events (25.9% vs. 18.3%) and shortening operation time preparing aortic cross clamp (248±64 minutes vs. 225±59 minutes) as compared to no-closure.ConclusionClinical outcomes of the third or more operations for valvular heart disease were acceptable in terms of intraoperative adverse events and in-hospital mortality rates. There were no differences in the incidence of intraoperative adverse events, early mortality and postoperative complications between third cardiac operation and fourth or more.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Surgical Results of Third or More Cardiac Valve Operation

Sohn

Hwang

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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“…[2][3][4] Adverse reactions from Teflon have also been reported in frontalis muscle suspension, implants in temporomandibular joint surgery, microvascular decompression for trigeminal neuralgia, and pericardial closure in rheumatic heart surgery. [5][6][7][8] Teflon felt is still used in neurosurgical dissection to displace and protect neurovascular structures for microvascular decompression of cranial nerves and to facilitate tumor dissection. We report an unusual case of a Teflon granuloma of the skull base incidentally discovered 1.5 years after endonasal resection of a large frontal meningioma.…”

Section: Until the 1980s Many Surgical Fields Usedmentioning

confidence: 99%

Teflon Granuloma of the Skull Base: A Complication of Endonasal Brain Surgery

Soose¹,

Snyderman²,

Kassam³

2007

Skull Base

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Teflon granuloma is an inflammatory giant-cell foreign-body reaction to polytetrafluoroethylene fibers or injection. Tissue augmentation with Teflon has dramatically declined over the past two decades because of its implication in granuloma formation. Nevertheless, Teflon felt is still commonly used in neurosurgical dissection and microvascular decompression. We report a patient with a Teflon granuloma of the skull base discovered 1.5 years after endonasal resection of an olfactory groove meningioma. The case highlights the clinical and radiographic diagnosis as well as the management of this unusual finding.

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“…At the time, it was believed that Teflon was a stable, inert substance that would neither resorb nor migrate . However, by the early 1990s, giant cell foreign‐body reactions associated with the use of Teflon were reported—particularly after laryngoplasty—providing evidence that Teflon was not absolutely inert as was once thought …”

Section: Introductionmentioning

confidence: 99%

“…6 However, by the early 1990s, giant cell foreign-body reactions associated with the use of Teflon were reported-particularly after laryngoplasty-providing evidence that Teflon was not absolutely inert as was once thought. 1,4,5,[7][8][9] During microvascular decompression (MVD), Teflon is the standard material used to displace the aberrant, symptom-inducing vascular loop characteristically underlying trigeminal neuralgia or hemifacial spasm, and pad the compressed cranial nerve at the root exit zone (REZ). [10][11][12] Intracranial Teflon granuloma (TG) occurs most frequently in the prepontine cistern after MVD for trigeminal neuralgia, with an incidence ranging from 1% to 7%.…”

Section: Introductionmentioning

confidence: 99%