Prevention of postcardiopulmonary bypass pericardial adhesions by a new resorbable collagen membrane

Interact Cardiovasc Thorac Surg. 2012 Apr;14(4):469-73. doi: 10.1093/icvts/ivr159. Epub 2012 Jan 19.

Abstract

Reduction in mediastinal adhesions is an issue in cardiac surgery. To evaluate a porcine-bioengineered collagen membrane (Cova™ CARD) intended to promote tissue regeneration, 18 sheep underwent a sternotomy and a 30 min period of cardiopulmonary bypass. They were divided into three equal groups: pericardium left open, placement of an e-polytetrafluoroethylene membrane (Preclude(®)) taken as a non-absorbable substitute comparator and placement of the absorbable Cova™ CARD membrane. Four months thereafter, the study animals underwent repeat sternotomy and were macroscopically assessed for the degree of material resorption and the intensity of adhesions. Explanted hearts were evaluated blindly for the magnitude of the inflammatory response, fibrosis and epicardial re-mesothelialization. The bioengineered membrane was absorbed by 4 months and replaced by a loosely adherent tissue leading to the best adhesion score. There was no inflammatory reaction (except for a minimal one in an animal). Fibrosis was minimal (P = 0.041 vs Preclude(®)). The highest degree of epicardial re-mesothelialization, albeit limited, was achieved by the bioengineered group in which five of six sheep demonstrated a new lining of mesothelial cells in contrast to two animals in each of the other groups. This collagen membrane might thus represent an attractive pericardial substitute for preventing post-operative adhesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biocompatible Materials* / adverse effects
  • Cardiopulmonary Bypass / adverse effects*
  • Collagen Type I* / adverse effects
  • Fibrosis
  • Foreign-Body Reaction / etiology
  • Foreign-Body Reaction / pathology
  • Heart Diseases / etiology
  • Heart Diseases / pathology
  • Heart Diseases / prevention & control*
  • Materials Testing
  • Membranes, Artificial*
  • Models, Animal
  • Pericardium / pathology*
  • Polytetrafluoroethylene
  • Regeneration
  • Sheep
  • Sternotomy
  • Time Factors
  • Tissue Adhesions / etiology
  • Tissue Adhesions / prevention & control*
  • Wound Healing

Substances

  • Biocompatible Materials
  • Collagen Type I
  • Membranes, Artificial
  • Polytetrafluoroethylene