Modified pericardial closure to protect cardiovascular structures during sternal reentry

Zapolanski, Alex; Fishman, Noel H.; Bronstein, M.; Ellertson, David G.; O'Connell, Thomas J.; Siegel, Sharon

doi:10.1016/0003-4975(90)90215-r

Cited by 13 publications

(5 citation statements)

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“…Perikardda meydana gelen bu adezyonlar ile ilgili yapılmış olan daha önceki çalışmalar da perikard duvarındaki mezotelial hücrelerin gösterdiği fibrinolitik aktivitede ve plazminojen aktive edicideki (plasminogen aktivating) [5] değişimlerin perikard adezyonlarının gelişmesini artırdığını gösterdi. Bu adezyonları azaltmak için geçmişte perikardın modifiye kapatılması, [7,8] perikardiyal sentetik ve biyolojik yamalar, [1,9,10] perikardın dekstran ile yıkanması [11] gibi birçok yöntem kullanılmış olmakla birlikte sorun halen tam olarak çözümlenememiştir. Son yıllarda özellikle hayvanlar üzerinde emilebilir jelatin (bioabsorbabl gelatin) shettler ile yapılmış olan çalışmalarda; [1,10] bu materyallerin perikardiyal yapışıklığı azaltmada çok faydalı olduğu görülmektedir.…”

Section: Discussionunclassified

Intraoperative changes in the pericardium: a study via electron microscope

Yener¹

2011

Turkish J Thorac Cardiovasc Surg

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Section: Discussionunclassified

Intraoperative changes in the pericardium: a study via electron microscope

Yener¹

2011

Turkish J Thorac Cardiovasc Surg

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“…Несмотря на это, многие кардиохирурги воздерживаются от ушивания перикарда во время КШ, опасаясь компрометации шунтов и синдрома тесного перикарда, при котором органы средостения (правый желудочек и часто маммарокоронарный шунт) вплотную прилегают к грудине [4]. Данные опасения оправданны: в нескольких публикациях высказано предположение, что ушивание перикарда после КШ может привести к «перекручиванию» или деформации аортокоронарных и / или маммарокоронарных шунтов [16][17][18].…”

Section: методы ушивания перикарда при коронарном шунтированииunclassified

An original method of pericardium closure after coronary artery bypass grafting

Кварацхелия¹,

Голубев²,

Авхадов³

et al. 2021

PKiK

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Different cardiac surgery centres have different views regarding pericardial suturing. However, there is limited scientific evidence confirming the advantage of one method over another, which disallows us from forming a general opinion regarding specialists. Here, we describe several well-known methods of suturing the pericardium and preventing traumatisation of coronary bypass grafts and analyse their weaknesses. An original technique of opening and suturing the pericardium is proposed to restore the physiological distinction between the pericardial cavity and the anterior mediastinum during coronary artery bypass grafting without the risk of compromising the functioning coronary bypass grafts and narrow mediastinal syndrome. The proposed method of suturing the pericardium received a patent for invention, No. 2733505, dated 2 October, 2020. In the A.N. Bakulev National Medical Research Center for Cardiovascular Surgery (Moscow, Russian Federation), this technique of suturing the pericardium has been routinely used since 2006. More than 2,000 intraoperative shunt scans have been performed in our department since 2009; all these scans were performed after the pericardium was closed, proving that the fear of compromising the shunts during pericardial suturing is unsupported.Received 17 December 2020. Revised 13 January 2021. Accepted 18 January 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: G.G. Kvaratskheliya, E.P. Golubev Data collection and analysis: U.S. Avkhadov, R.M. Ibragimov Drafting the article: G.G. Kvaratskheliya, E.P. Golubev Critical revision of the article: E.U. Asymbekova, B.E. Rustamov, L.S. Shakhnazaryan, Yu.I. Buziashvili Final approval of the version to be published: G.G. Kvaratskheliya, E.P. Golubev, U.S. Avkhadov, R.M. Ibragimov, B.E. Rustamov, E.U. Asymbekova, L.S. Shakhnazaryan, Yu.I. Buziashvili

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“…In Group 3 (n=5, MSC group), skin and subcutaneous tissues were opened, contact of tissues with air and blood was maintained. Subsequently, 3¥10 6 MSCs were applied into the skin and subcutaneous tissues and the skin was closed.…”

Section: In Vivo Rat Modelmentioning

confidence: 99%

“…[5] To reduce this adhesion, several methods have been used, such as to close only the regions over the large vessels, to use different synthetic and biological grafts, and to wash with dextran. [6] Damaged tissue repair is completed in three stages. Tissue repair begins with hemostasis and, following the inf lammatory period ending within 24 to 48 hours, proliferative and maturation stages occur.…”

mentioning

confidence: 99%

Effects of mesenchymal stem cells to prevent adhesions for vascular reoperations: An experimental study

Kabalcı¹,

Zengin²,

Muluk³

et al. 2019

Turk J Vasc Surg

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Objectives: In the present study, we aimed to investigate whether mesenchymal stem cells (MSCs) were useful to reduce cutaneous adhesions, particularly for vascular reoperations. Materials and methods: In this experimental study, 12 adult male Wistar Albino rats were used. In Group 1 (n=2, negative control group), no incision was performed. In Group 2 (n=5, positive control group), skin and subcutaneous tissues were incised. In Group 3 (n=5, MSC group), skin and subcutaneous tissues were incised and 3×106 MSCs were applied. Macroscopic scoring of adhesion and histopathological scoring of tissue repair response were evaluated. Results: Macroscopic view of the adhesion values (P adjusted <0.0175), histopathological evaluation values (histiocytic response, vascularization, and granulocytic response and total response) (P adjusted <0.0175), and collagen deposit values (P adjusted <0.0175) of Group 3 were significantly lower than Group 2. Conclusion: Our study results suggest that the use of MSCs seems to be useful to prevent adhesion formation in cutaneous injuries and that MSCs promote wound healing without adhesions in the experimental setting.

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Modified pericardial closure to protect cardiovascular structures during sternal reentry

Cited by 13 publications

References 0 publications

Intraoperative changes in the pericardium: a study via electron microscope

Intraoperative changes in the pericardium: a study via electron microscope

An original method of pericardium closure after coronary artery bypass grafting

Effects of mesenchymal stem cells to prevent adhesions for vascular reoperations: An experimental study

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