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Fibrin Sealing in Surgical and Nonsurgical Fields pp 55–63Cite as

Fibrin Sealant Application to Improve Cardiomyoplasty Management

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Abstract

Dynamic cardiomyoplasty (DC) entails the properly mobilized latissimus dorsi (LD) muscle to be wrapped around the heart and to be paced synchronously with the cardiac systole to improve cardiac performance in end-stage heart failure and restrain further ventricular dilatation. Postoperative management requires a 2-week rest period to enhance intermuscular adhesion formation. This study tested an alternative approach by applying a fibrin glue (Tissucol, Immuno, Austria) at the intermuscular interface aiming at optimal heart/LD contact and consequent earlier postoperative LD assistance. Eight goats were submitted to DC. In six animals (group A) fibrin glue was used during surgery. The biological sealant was sprayed (Tissumat, Immuno, Austria) over the contact surfaces. In this group wrapped LD stimulation was started on day 1 after surgery. In two goats (group B) no sealant was added, and standard postoperative protocol (first 2-week rest period) was followed. Both groups were extensively studied 2 weeks from surgery to detect any muscle displacement or damage in group A and to compare adhesion formation extent and strength. Group A animals showed slight hemodynamic improvement (right ventricular systolic pressure from 26 ± 6 to 30 ± 8 mmHg during assisted beats; p = 0,04), and no wrapped muscle dislocation was observed despite anticipated stimulation. At the heart/LD opposing surfaces strong and effective adhesions were detected. Histology confirmed early paced wrapped muscle viability and partial muscle fiber transformation. Group B animals showed weak adhesions in comparison with fibrin glue treated muscles. In conclusion Tissucol glue represents a valuable tool to provide optimal intermuscular fixation and allow earlier LD stimulation and related cardiac assistance.

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Authors
  1. R. Lorusso
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  2. O. Alfieri
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  3. T. Van Der Nagel
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  4. J. Habets
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  5. M. Havenith
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  6. F. Van Der Veen
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  7. O. C. Penn
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Editor information

Editors and Affiliations

  1. Ludwig-Boltzmann-Institut für experimentelle und klinische Traumatologie, Donaueschingenstraße 13, 1200, Wien, Austria

    Günther Schlag

  2. II. Universitätsklinik für Chirurgie, Spitalgasse 23, 1090, Wien, Austria

    Ernst Wolner

  3. Abteilung für Herz-Thoraxchirurgie, II. Universitätsklinik für Chirurgie, Währinger Gürtel 18-20, 1090, Wien, Austria

    Franz Eckersberger

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© 1995 Springer-Verlag Berlin Heidelberg

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Lorusso, R. et al. (1995). Fibrin Sealant Application to Improve Cardiomyoplasty Management. In: Schlag, G., Wolner, E., Eckersberger, F. (eds) Fibrin Sealing in Surgical and Nonsurgical Fields. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79227-4_7

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  • DOI: https://doi.org/10.1007/978-3-642-79227-4_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58381-3

  • Online ISBN: 978-3-642-79227-4

  • eBook Packages: Springer Book Archive

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