title: Histologic evaluation of stapled right atrial appendages with fabric buttressing.
abstract: OBJECTIVE
  The aim of this study was to histologically evaluate the importance of using buttressing materials in stapling the atrial appendages.
  
  
  METHODS
  We stapled the right atrial appendage with a commercial apparatus in 11 mongrel dogs. To evaluate the efficiency of using a buttressing material as an adjunct to stapling, we conducted 30-day studies without (group A: n = 2) or with buttressing material (group B: n = 3) and 90-day studies without (group C: n = 3) or with buttressing material (group D: n = 3) and thereafter made assessments using Doppler echocardiography and performed histologic analyses on all stapled appendages.
  
  
  RESULTS
  During surgery, blood oozing from the stapling sites was observed in four of five cases of groups A and C; with buttressing, there was no oozing in groups B and D. In groups A and B, we observed the myocardium of the appendage being focally replaced with fibrous tissue. Myocardium in group C was infiltrated diffusely with loose fibrous tissue and in group D had been almost completely replaced with fibrous tissue.
  
  
  CONCLUSIONS
  The buttressing material was useful not only in preventing oozing but also likely promoting the growth of fibrous tissue in the right atrial appendage.
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Fumoto
authors.forename: A Marc
authors.initials: AM
authors.lastname: Gillinov
authors.forename: D Geoffrey
authors.initials: DG
authors.lastname: Vince
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.forename: Diyar
authors.initials: D
authors.lastname: Saeed
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi