Postsurgical Intrapericardial Adhesions: Mechanisms of Formation and Prevention Aldo Cannata, MD, Duccio Petrella, MD, Claudio Francesco Russo, MD, Giuseppe.

Slides:

Advertisements

Similar presentations

Morphologic Spectrum of Ventriculoarterial Connection in Hearts With Double Inlet Left Ventricle: Implications for Surgical Procedures Hideki Uemura, MD,

Advertisements

Prevention of Postoperative Pericardial Adhesions With a Novel Regenerative Collagen Sheet Hiroyuki Tsukihara, MD, Shinichi Takamoto, MD, PhD, Kazuo.

Ricardo S. Santos, MD, Jianmin Gan, MD, Carl J

Squamous Cell Carcinoma of the Pericardium Found During Coronary Bypass Surgery of Possible Cutaneous Origin Alan P. Kypson, MD, Curtis A. Anderson,

Chronic Heart Perforation With 13

Left Ventricular Bronchogenic Cyst

Chest Wall Angiolipoma Complicating Von Recklinghausen Disease

Collision Tumor of Esophagus: Report of Three Cases

Michael A. Long, MMed The Annals of Thoracic Surgery

Louis A. Brunsting, MD, Robert S. Binford, MD, Kimberly C

Bronchiolitis Obliterans Organizing Pneumonia Due to Titanium Nanoparticles in Paint Tong-Hong Cheng, MD, Fu-Chang Ko, MD, Junn-Liang Chang, MD, Kuo-An.

Bioabsorbable Gelatin Sheets Latticed With Polyglycolic Acid Can Eliminate Pericardial Adhesion Ichiro Yoshioka, MD, Yoshikatsu Saiki, MD, Kei Sakuma,

Ashwin K. Thiagarajasubramanian, MD, Sandip K. Zalawadiya, MD, Luis C

Short-Course Rapamycin Treatment Preserves Airway Epithelium and Protects Against Bronchiolitis Obliterans Jacob R. Gillen, MD, Yunge Zhao, MD, PhD,

Cardiac Cavernous Hemangioma Coexisting With Pulmonary Cavernous Hemangiomas and Giant Hepatic Hemangioma Chunping Wang, MD, Hao Chen, MD, Lin Sun, MD,

Effectiveness of Hyperbaric Oxygen Therapy for Hearing Loss After Cardiac Surgery Giuseppe Bruschi, MD, Giuseppe Tarelli, MD, Paola Colombo, MD, PhD,

Giant Costal Osteochondroma in a Man With Multiple Exostoses

Mitral Valve Stenosis Progression Due to Severe Calcification on Glutaraldehyde- Treated Autologous Pericardium: Word of Caution for an Attractive Repair.

Ray K. Chihara, MD, PhD, Seth D. Force, MD

Surgical Removal and Replacement of Chronically Implanted Transcatheter Aortic Prostheses: How I Teach It Abeel A. Mangi, MD, Mahesh Ramchandani, MD,

Primary Chordoma of the Lung

Successful resection of an epicardial cyst

Pulmonary Lymphangioma

Radiologically Indeterminate Pulmonary Cysts in Birt-Hogg-Dubé Syndrome Takuya Onuki, MD, PhD, Yukinobu Goto, MD, PhD, Masami Kuramochi, MD, PhD, Masaharu.

Susanne Lison, MD, Michael Spannagl, MD, PhD, Wulf Dietrich, MD, PhD

Early Constrictive Epicarditis After Coronary Artery Bypass Surgery

Christopher W. Seder, MD, Bassem T. Elhassan, MD, Dennis A

Nodular Lymphoid Hyperplasia of the Lung: A Very Rare Disease Entity

Reduction of retrosternal and pericardial adhesions with rapidly resorbable polymer films Naoki Okuyama, MD, Catherine Y Wang, MD, Eric A Rose, MD, Kathleen.

Public policy and the practicing physician

Who Do You Say You Are? The Annals of Thoracic Surgery

Nassrene Y. Elmadhun, MD, Ashraf A. Sabe, MD, Antonio D

Robotic Resection of an Aortic Valve Papillary Fibroelastoma

Use of Amiodarone After Major Lung Resection

Surgical Dilemmas: Diagnosis and Treatment of Atrial Plasmacytoma

Abel Gómez-Caro, MD, Pedro Arguis, MD The Annals of Thoracic Surgery

Sternal Closure With Tie Bands: A Word of Caution

Accessory Liver Lobe in the Left Thoracic Cavity

Invasive Desmoplastic Fibroblastoma in the Chest Wall

Video-Assisted Thoracoscopic Surgery for a Cystic Seminoma of the Mediastinum Mong-Wei Lin, MD, Yih-Leong Chang, MD, Chen-Tu Wu, MD, Yung-Chie Lee, MD,

Fadia Haddad, MD, Issam El-Rassi, MD, Fadi G

Aneurysmal Bone Cyst of Sternum

Marc de Perrot, MD, MSc The Annals of Thoracic Surgery

Eric H. Sladek, MD, Kevin D. Accola, MD The Annals of Thoracic Surgery

Embolized Methyl Methacrylate to the Right Atrium After Kyphoplasty

Sublocalization of Cardiac Involvement in Sarcoidosis and Surgical Exclusion in Patients With Congestive Heart Failure Masanori Hirota, MD, PhD, Minoru.

Editorial Board, January 2010

Mitral Valve Necrosis After Cardiac Surgery Using Gelatin-Resorcinol-Formaldehyde Glue Yuki Tanaka, MD, Tadashi Kitamura, MD, PhD, Yurie Miyata, MD,

Completely Thrombosed Tricuspid Pouch Mimicking a Cardiac Tumor

An Unusual Cause of Hemoptysis in a Young Woman

Vascular Leiomyoma of the Pulmonary Artery

The Unifocal Bilateral Bidirectional Cavopulmonary Anastomosis

Arteriovenous Malformation in the Anterior Mediastinum

Surgical Treatment in a Case of Cogan's Syndrome Complicated With Proximal Aortic Vasculitis Mehmet Kaya, MD, Korhan Erkanlı, MD, Furkan Kılınç, MD,

Chondroid Syringoma: A Rare Tumor of the Chest Wall

Ricardo S. Santos, MD, Jianmin Gan, MD, Carl J

Patrick O. Myers, MD The Annals of Thoracic Surgery

Treatment of Plastic Bronchitis

Direct Transaortic TEVAR: An Alternative Option for Selected Patients With Unsuitable Peripheral Access Luca Botta, MD, PhD, Giuseppe Bruschi, MD, Pasquale.

Primary Myelolipoma of the Chest Wall

Invited Commentary The Annals of Thoracic Surgery

Robert Lee Replogle, September 30, 1931–May 9, 2016

The American Board of Thoracic Surgery: Update

Mature Cystic Teratoma With Malignant Transformation to Adenocarcinoma

“Transitions” for Cardiothoracic Surgeons Now Listed on the Web:

Posttraumatic Main Left Bronchial Rupture

Experience With Bovine Pericardium for the Reconstruction of the Aortic Arch in Patients Undergoing a Norwood Procedure Victor O. Morell, MD, Peter A.

Clemens Aigner, MD, Ernst Wolner, MD, Werner Mohl, MD, PhD

The Impact of New Technology on Cardiothoracic Surgical Practice

J. Alberto Lopez, MD The Annals of Thoracic Surgery

Presentation transcript:

Postsurgical Intrapericardial Adhesions: Mechanisms of Formation and Prevention Aldo Cannata, MD, Duccio Petrella, MD, Claudio Francesco Russo, MD, Giuseppe Bruschi, MD, Pasquale Fratto, MD, Marcello Gambacorta, MD, Luigi Martinelli, MD The Annals of Thoracic Surgery Volume 95, Issue 5, Pages 1818-1826 (May 2013) DOI: 10.1016/j.athoracsur.2012.11.020 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diagram shows the early steps for the formation of postsurgical intrapericardial adhesions: 1 = normal pericardial mesothelial cells, tightly adherent to the adjacent cells and the basal lamina, with a flattened shape and covered by microvilli on the luminal surface; 2 = rounded pericardial mesothelial cells, separated from the adjacent cells and the basal lamina, devoid of microvilli; 3 = rounded mesothelial cell free-floating into the pericardial cavity; 4 = fibrin accumulations along the areas devoid of both mesothelial cells and basal lamina with exposure of the submesothelial connective tissue; 5 = bundles of fibrin that fuse denuded areas of visceral and parietal pericardium; 6 = pericardial cavity. The Annals of Thoracic Surgery 2013 95, 1818-1826DOI: (10.1016/j.athoracsur.2012.11.020) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Chart shows pathogenesis of postsurgical intrapericardial adhesions. Methods to prevent the formation of adhesions are reported within black boxes, and the dotted lines show their level of action within the pathogenetic mechanism. (HA = hyaluronic acid; PEG = polyethylene glycol; PMC = pericardial mesothelial cells.) The Annals of Thoracic Surgery 2013 95, 1818-1826DOI: (10.1016/j.athoracsur.2012.11.020) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Diagram shows the mechanism of action of sealants and resorbable membranes. A layer of product (1) impedes the adherence and accumulation of fibrin on the exposed submesothelial connective tissue along the epicardium (2), preventing the fusion between the visceral and parietal pericardium. The Annals of Thoracic Surgery 2013 95, 1818-1826DOI: (10.1016/j.athoracsur.2012.11.020) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Calretinin antibody staining in this photomicrograph of a specimen from the anterior wall of the left ventricle, 1 year after treatment with Coseal, shows the integrity of the mesothelial cells along both the layers of the pericardium, without connective tissue between the visceral and parietal pericardium. The Annals of Thoracic Surgery 2013 95, 1818-1826DOI: (10.1016/j.athoracsur.2012.11.020) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Photomicrograph shows a specimen from the inferior wall of the left ventricle, 1 year after operation and not treated with sealant. The space between the pericardial layers is filled by loose connective tissue of the adhesions. Hematoxylin and eosin stain. The Annals of Thoracic Surgery 2013 95, 1818-1826DOI: (10.1016/j.athoracsur.2012.11.020) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions