Key result
Bovine pericardium patch closure complicates resternotomy due to severe retrosternal adhesions.
Why the study?
Closure of the pericardium with bovine pericardium patches after open heart operations may increase the difficulty of resternotomy, but this has not been well characterized.
Does pericardial closure with bovine pericardium increase the difficulty of subsequent resternotomy?
Case Report (n=4)
Does pericardial closure with bovine pericardium increase the difficulty of subsequent resternotomy?
Bovine pericardium patches for pericardial closure cause severe adhesions to the sternum, increasing the difficulty of subsequent resternotomies, and their use should be discontinued.
Answers are grounded in this paper and cite their sources.
Bovine pericardium patches may complicate resternotomy; leaves open optimal closure techniques in reoperation-prone patients.
To reduce the risk of damage to the anterior surface of the right ventricle after resternotomy, it has been recommended that the pericardium be closed with a patch after open heart operations. We have examined 4 patients undergoing resternotomy for the third time 3 to 8 years after bovine pericardium valve replacement. On each occasion the pericardium was closed with a patch of bovine pericardium. In all cases, the patch was frozen to the inner aspect of the sternum, increasing the difficulty of resternotomy. Histological examinations of the patches confirmed dense fibrous connective tissue, patchy calcification, and foreign body giant cell reaction. Bovine pericardium appears to increase the difficulty of repeat cardiac operations. We recommend its use be discontinued.
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Eng et al. (1989) conducted a case report in Patients undergoing resternotomy (n=4). Bovine pericardium patch for pericardial closure was evaluated on Difficulty of resternotomy and histological findings. Pericardial closure with a bovine pericardium patch increased the difficulty of resternotomy in all 4 patients due to the patch freezing to the inner aspect of the sternum.
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