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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 430-433, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JG Vincent, SH Skotnicki, JJ van der Meer and K Kubat
The edge of tissue left after ventricular aneurysmectomy requires very
careful placement and tying of the sutures. The use of Teflon felt as a
support appears to redistribute the pressure and thus prevent the sutures
from cutting through the vulnerable tissue. In many cases, Teflon felt
reinforcement is preferred to direct unsupported closure because of
perioperative of immediately postoperative bleeding complications. However,
the unavoidable full immobilization of the sutured area, the possible risk
of foreign body infection, and the extensive adhesions and calcification in
the long term compelled us to search for a better alternative, combining
the convenience of both methods and limiting the risks. PDS (polydioxine)
resorbable pledgets and strips, provided by Ethicon GmbH, were used as a
suture support during the past 2 years for closure of 29 ventricular
aneurysmectomies and four ischemic ventricular septal defects, all except
one in combination with coronary bypass grafting. The PDS material was easy
and efficient to apply and caused no complications during and after the
operation. In one case, we had the opportunity to review the supported scar
during a second operation for new coronary grafts after 18 months. The
formerly feared "linear scar petrification," usual after use of Teflon
felt, was absent. The scar was free from difficult adhesions. Our initial
experience suggests the further extensive use of this resorbable material
as a support for various sutures at risk.
ARTICLES
Resorbable suture support for ventricular aneurysmectomy
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