Oxidized regenerated cellulose in cardiac computer tomography imaging.
Oxidized regenerated cellulose is widely used as a bioabsorbable topical hemostatic agent. Postoperative visualization of this material through routine chest imaging, such as conventional radiography, computer tomography (CT), magnetic resonance imaging as well as sonography, may prove difficult and, to our knowledge, is not described in the literature. We describe a case where the mediastinal packing with Surgicel™ Nu-Knit™ after a mitral valve repair procedure led to a delayed obstruction of the superior vena cava, necessitating a re-thoracotomy and curettage of the hemostatic material. The hemostatic agent was not prospectively interpreted as the cause of a severe upper inflow restriction, despite repeated imaging. Retrospectively, the hemostatic material as a cause of the upper inflow obstruction could have been identified earlier if its presence would have been known to the radiologist. We strongly recommend that the surgeon inform the radiologist that such materials were used to improve the diagnostic yield of CT interpretation.
Clinic for Cardiac Surgery, City Hospital Triemli, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland. thomas.syburra@triemli.stzh.ch
Thomas
T
Syburra
Dominik
D
Weishaupt
Kirk
K
Graves
Michele
M
Genoni
D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D002483:Cellulose, Oxidized / Q000009:adverse effects*; D003475:Curettage; D005260:Female; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D011237:Predictive Value of Tests; D012086:Reoperation; D012307:Risk Factors; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel