Abstract
ObjectivePostoperative intrapericardial adhesion increases the risk of complications in patients undergoing reoperation. We investigated the effect of a bioabsorbable dextrin hydrogel (DHG) on the formation of intrapericardial adhesions.MethodsIntrapericardial adhesion was surgically induced in Japanese white rabbits with DHG treatment (Adh + DHG) or without DHG treatment (Adh). The sham group was not treated with DHG and intrapericardial adhesion was not induced. The extent of intrapericardial adhesion was assessed by adhesion scoring and crystal violet staining of the pericardial cavity. Bromodeoxyuridine (BrdU) uptake assay was performed to assess the proliferative response to the injury in the tissue beneath the intrapericardial adhesion.ResultsThe Adh + DHG group showed looser intrapericardial adhesions compared to the Adh group. The adhesion area of the Adh + DHG group was 4.6 ± 2.2%, whereas that of the Adh group was 32.6 ± 6.4% at the end of the 28-day observation period (p < 0.01). The induction of intrapericardial adhesion resulted in a proliferative response mainly in the cardiac tissue just beneath the adhesion. There were 48.6 ± 10.7 cells/0.1 mm2 BrdU-positive cells in the Adh + DHG group and 135.7 ± 23.8 cells/0.1 mm2 BrdU-positive cells in the Adh group on day 28 (p < 0.05).ConclusionThese findings indicate that DHG effectively prevented intrapericardial adhesion in this model.
Highlights
Cardiovascular diseases are becoming increasingly prevalent in our aging society
Postoperative intrapericardial adhesion is a common phenomenon in cardiovascular surgery, which increases the risk of complications including organ injury, bleeding, prolonged cardiopulmonary bypass time, and increased surgical mortality [4,5,6,7]
The grading score of the Adh + dextrin hydrogel (DHG) group was significantly lower at day 7 and day 28 compared with that of the Adh group
Summary
Cardiovascular diseases are becoming increasingly prevalent in our aging society. Since the risk factors, including age, are common to various cardiovascular diseases, the chances of the same patient presenting multiple cardiovascular diseases is high [1]. Patients with congenital heart diseases frequently undergo multiple stages of surgical repair. Postoperative intrapericardial adhesion is a common phenomenon in cardiovascular surgery, which increases the risk of complications including organ injury, bleeding, prolonged cardiopulmonary bypass time, and increased surgical mortality [4,5,6,7]. The problem of postoperative intrapericardial adhesion needs to be addressed to improve the outcome of patients who might undergo repeated surgery
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