BioGlue: a protective barrier after pericardiotomy.
BACKGROUND
Repeat operation on the heart composes about 20% of procedures in contemporary practice of cardiac surgery. A sheet of material providing a barrier against cardiac adhesion to the sternum would be desirable.


METHODS
Anterior pericardiectomy was performed in rats. BioGlue milled to a 0.4 mm sheet was applied to the anterior surface of the heart in 16 rats; Surgicel plus liquid BioGlue in seven; Surgicel alone in three; and nothing (control) in eight. The operative site was reexamined for gross evidence of adhesion, scarring, and residual BioGlue 1, 3, and 6 months later.


RESULTS
There was formation of a loose connective tissue barrier containing blood vessels without scar formation in all animals treated with milled BioGlue. Surgicel plus BioGlue resulted in a barrier containing more denser connective tissue with collagen fibers. Surgicel alone resulted in a similar barrier. No barrier formed in the control experiments.


CONCLUSIONS
A sheet of milled BioGlue applied over the surface of the heart but not attached to it after partial pericardiectomy has been shown to stimulate formation of a loose connective tissue barrier containing blood vessels. This barrier is unique compared to dense fibrous scar which usually forms after opening the pericardium for cardiac operations.
Division of Cardiovascular and Thoracic Surgery, LDS Hospital, Salt Lake City, Utah, USA.
Nai Dong
ND
Wang
Donald B
DB
Doty
John R
JR
Doty
Umit
U
Yuksel
Robert
R
Flinner
D000818:Animals; D002483:Cellulose, Oxidized; D003094:Collagen / Q000378:metabolism; D003238:Connective Tissue / Q000098:blood supply / Q000473:pathology; D008297:Male; D010492:Pericardiectomy / Q000379:methods*; D010496:Pericardium / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control; D019736:Prostheses and Implants; D011506:Proteins / Q000008:administration & dosage*; D051381:Rats; D020318:Rats, Long-Evans; D012086:Reoperation; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control; D014945:Wound Healing / Q000502:physiology
C472676:Bio-glue; D002483:Cellulose, Oxidized; D011506:Proteins; C013695:Surgicel; D003094:Collagen