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The Annals of Thoracic Surgery, Vol 43, 383-385, Copyright © 1987 by The Society of Thoracic Surgeons
JC Opie, AJ Larrieu and IS Cornell
Four patients' experience with two varieties of pericardial substitutes has
been evaluated. Two patients received glutaraldehyde-preserved,
formalin-fixed bovine bioprosthetic pericardial substitutes. These were
associated with dense prosthesis-to-epicardium adhesions and the formation
of a thick gelatinous peel. Two other patients received
glutaraldehyde-preserved, ethanol-fixed bovine bioprosthetic pericardial
substitutes. One patient had minimal prosthesis-to- epicardium adhesions,
and the remaining patient demonstrated moderate prosthesis-to-epicardium
adhesions with giant-cell and lymphocyte fibrosis. In all patients
prosthesis-to-sternum adhesions were minimal. These observations suggest
that careful washing is essential in all bioprosthetic implants to
eliminate residual preservatives and fixatives. In addition, preservation
in ethanol is associated with less prosthesis-epicardium reaction than is
formalin preservation. Both products are successful in easing reentry, and
no episode of infection has been associated with either prosthesis.
ARTICLES
Pericardial substitutes: delayed reexploration and findings
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