Prevention of postcardiopulmonary bypass pericardial adhesions by a new resorbable collagen membrane
Résumé
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. © The Author 2012.
Mots clés
collagen membrane
controlled study
epithelization
inflammation
mesothelium cell
nonhuman
pericardium adhesion
priority journal
repeat procedure
tissue adhesion
tissue regeneration
Animals
Biocompatible Materials
Cardiopulmonary Bypass
Collagen Type I
Fibrosis
Foreign-Body Reaction
Heart Diseases
Materials Testing
Membranes
Artificial
Models
Animal
Pericardium
biomaterial
Polytetrafluoroethylene
politef
Regeneration
Sheep
animal experiment
Sternotomy
animal tissue
Time Factors
Tissue Adhesions
Wound Healing
article
bioengineering