Aortic tube grafts wrapping with hemostatic fleeces reduces postoperative pericardial effusions.
Pericardial effusions often complicate the postoperative course of ascending aortic surgery. We evaluated whether an unconventional use of hemostatic fleeces (TachoSil, Nycomed; Austria), wrapped around aortic tube grafts, may reduce such complication. Twenty-nine consecutive patients undergoing button-Bentall were submitted - according to surgeon's choice - to 360 degrees wrapping of the aortic grafts with hemostatic fleeces immediately before sternal wiring (11 patients - group A) or sternal wiring without any wrapping of the prosthesis (18 patients - group B). Hospital outcome was recorded. No differences were recorded in hospital mortality and major organ morbidity. When pericardial complications were considered, group A showed lower chest drains (P=0.0001), time of chest drainage (P=0.002), pretamponade/tamponade with need for pericardiocentesis (P=0.039), predischarge echocardiographic amount of pericardial effusion (P=0.026), fever (P=0.029), need for anti-inflammatory (P=0.05) or antibiotic drugs (P=0.007), hospital stay (P=0.010) and white blood cell count (P=0.016 on postoperative day 3; P=0.014 on day 6). Wrapping of aortic tube grafts with hemostatic fleeces is effective in reducing pericardial effusion and its deleterious effects following aortic surgery.
Onorati
F
F
Cardiac Surgery Unit, Magna Graecia University, Catanzaro, Italy. frankono@libero.it
Pasceri
E
E
Scalas
C
C
Santarpino
G
G
Mastroroberto
P
P
Indolfi
C
C
Renzulli
A
A
D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000517:prevention & control*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D013917:Thrombin; D016896:Treatment Outcome; D014463:Ultrasonography
D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin