title: The pressures of surgicel(®) in cardiac surgery.
abstract: Surgicel® is bioabsorbable hemostatic mesh, frequently packed around oozing surgical bed. We report two morbidities due to it. Following transannular patch repair for Fallot's tetralogy, Surgicel® was packed around distal main pulmonary artery. Echocardiography in the intensive care unit (ICU) showed right ventricular dysfunction due to extrinsic obstruction and complete occlusion of left pulmonary artery (LPA) flows. Another patient with arterial switch operation had postoperative fibrillatory cardiac arrest, needing resuscitation with internal cardiac massage. The arrest was triggered by coronary ischemia due to periaortic compression. Both instances were caused by hygroscopic nature of Surgicel®, which absorbed blood, swelled, and compressed the luminal tissues.
authors.affiliation: Department of Cardiac Surgery, The Madras Medical Mission, Institute of Cafardiovascular Diseases, Chennai, Tamil Nadu, India.
authors.forename: Niket Dilip
authors.initials: ND
authors.lastname: Arora
authors.affiliation: Department of Cardiac Surgery, The Madras Medical Mission, Institute of Cafardiovascular Diseases, Chennai, Tamil Nadu, India.
authors.forename: Roy
authors.initials: R
authors.lastname: Varghese
authors.affiliation: Department of Cardiac Surgery, The Madras Medical Mission, Institute of Cafardiovascular Diseases, Chennai, Tamil Nadu, India.
authors.forename: Sreeja
authors.initials: S
authors.lastname: Pavithran
authors.affiliation: Department of Cardiac Surgery, The Madras Medical Mission, Institute of Cafardiovascular Diseases, Chennai, Tamil Nadu, India.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Kothandam
keywords: Bleeding; bleeding control; blood; coagulants (topical; coagulation/anticoagulation; complications; congenital heart disease (CHD); experimental); surgery; systemic