title: Aortic tube grafts wrapping with hemostatic fleeces reduces postoperative pericardial effusions.
abstract: 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.
authors.affiliation: Cardiac Surgery Unit, Magna Graecia University, Catanzaro, Italy. frankono@libero.it
authors.forename: F
authors.initials: F
authors.lastname: Onorati
authors.forename: E
authors.initials: E
authors.lastname: Pasceri
authors.forename: C
authors.initials: C
authors.lastname: Scalas
authors.forename: G
authors.initials: G
authors.lastname: Santarpino
authors.forename: P
authors.initials: P
authors.lastname: Mastroroberto
authors.forename: C
authors.initials: C
authors.lastname: Indolfi
authors.forename: A
authors.initials: A
authors.lastname: Renzulli
mesh_terms: 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
chemical_list: D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin