BioGlue: a protective barrier after pericardiotomy.

Background: Repeat operation on the heart composes about 20% of procedures in contemporary practice of cardiac surgery. A sheet of material providing a barrier against cardiac adhesion to the sternum would be desirable.

Methods: Anterior pericardiectomy was performed in rats. BioGlue milled to a 0.4 mm sheet was applied to the anterior surface of the heart in 16 rats; Surgicel plus liquid BioGlue in seven; Surgicel alone in three; and nothing (control) in eight. The operative site was reexamined for gross evidence of adhesion, scarring, and residual BioGlue 1, 3, and 6 months later.

Results: There was formation of a loose connective tissue barrier containing blood vessels without scar formation in all animals treated with milled BioGlue. Surgicel plus BioGlue resulted in a barrier containing more denser connective tissue with collagen fibers. Surgicel alone resulted in a similar barrier. No barrier formed in the control experiments.

Conclusions: A sheet of milled BioGlue applied over the surface of the heart but not attached to it after partial pericardiectomy has been shown to stimulate formation of a loose connective tissue barrier containing blood vessels. This barrier is unique compared to dense fibrous scar which usually forms after opening the pericardium for cardiac operations.