1. Off-pump epicardial tissue sealing—a novel method for atrioventricular disruption complicating mitral valve procedures 
Albert Schuetz, MD, PhD, Costas Schulze, MD, Stephen M Wildhirt, MD, PhD 
The Annals of Thoracic Surgery 
Volume 78, Issue 2, Pages (August 2004)
DOI: /j.athoracsur

2. Fig 1
Placement in layers of the collagen system with fibrinogen based coating (Tacho Comb, Nycomed Pharma, Linz, Austria) is shown on the posterolateral aspect of the heart. Each layer is applied by manual compression for 10–15 minutes starting in the center of the bleeding sit. Between 3–6 layers may be necessary to achieve hemostasis. The layers are placed in overlapping fashion thereby creating a large area of mechanical resistance against intracardiac bleeding.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

3. Fig 2
Survival at 1-year follow-up is shown. No deaths occurred in the “tissue sealing” group compared with 25% survival in the surgical repair group. *p < 0.05 versus surgical repair.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

4. Fig 3
The amounts of blood products given intraoperatively (top) and during the postoperative (bottom) course. In the “surgical repair” group a significantly higher number of units of fresh frozen plasma (FFP) were given intraoperatively and postoperatively as well as more units of red blood cells (RBCs) postoperative when compared with the “tissue sealing” group. *p < 0.05 versus surgical repair. (White bars = tissue sealing; black bars = surgical repair.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )