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J Thorac Cardiovasc Surg 2004;127:1228
© 2004 The American Association for Thoracic Surgery

Letter to the editor

Microfibrillar collagen hemostat in cardiac surgery

The Carolinas Heart Institute, Carolinas Medical Center, Charlotte, NC 28203 USA

To the Editor:

The September 2003 article of rlak and associates¹ extolled the virtues of microfibrillar collagen (MC) as a hemostatic agent. Studies by our own group support the conclusion that this compound is highly effective in cardiac surgery.² However, I must sound more than a word of caution.

When in the early 1980s we have applied MC frequently in the course of heart operations, we encountered cases of unexplained brain injuries. Because we suspected MC as the culprit, the substance was subjected to extensive in vitro and in vivo investigation. We found that MC-containing shed blood, if returned to the circulation by either pump-suction or cell-salvage devices, may readily pass 40-mm pore-size filters and lodge in vital organs, including the brain.³

For this reason, we have recommended that blood contaminated by MC should not be reused. Once MC has been applied, only waste suction should be applied to handle shed blood.

	References

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1. Sirlak M, Eryilmaz S, Yazicioglu L, Kiziltepe U, Eyileten Z, Durdu MS, et al. Comparative study of microfibrillar collagen hemostat (Colgel) and oxidized cellulose (Surgicel) in high transfusion-risk cardiac surgery. J Thorac Cardiovasc Surg. 2003;126:666–670[Abstract/Free Full Text]
   
2. Robicsek F, Born GV. The control of bleeding after cardiopulmonary bypass by the intrapericardial instillation of fresh frozen plasma and platelets with microfibrillar collagen. Thorac Cardiovasc Surg. 1984;32:127–130[Medline]
   
3. Robicsek F, Duncan GD, Born GV, Wilkinson HA, Masters TN, McClure M. Inherent dangers of simultaneous application of microfibrillar collagen hemostat and blood-saving devices. J Thorac Cardiovasc Surg. 1986;92:766–770[Abstract]
   

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francis Robicsek Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Robicsek, F. Search for Related Content PubMed PubMed Citation Articles by Robicsek, F. Related Collections Cardiac - other Related Article