Protection of the internal mammary artery pedicle with polytetrafluoroethylene membrane

Kenton J Zehr, P. C. Lee, R. S. Poston, A. M. Gillinov, Ralph H Hruban, D. E. Cameron

Research output: Contribution to journalArticle

Abstract

With increasing frequency, reoperative coronary artery bypass surgery is being performed in the setting of a patent internal mammary artery (IMA) graft. Injury to the IMA graft at reoperation can result in ischemic myocardial injury and cardiac arrest. This descriptive laboratory study examined use of a polytetrafluoroethylene (PTFE) membrane wrap to protect the IMA pedicle during sternal reentry. Six pigs (25-30 kg) underwent median sternotomy and takedown of left and right IMAs. Grafts were implanted in the epicardium by a modified Vineberg procedure. In each animal, one IMA was wrapped circumferentially with PTFE, while the contralateral bare IMA served as the control. Redo sternotomy was performed 3 months later. Severe adhesions between chest wall, myocardium, and bare IMA grafts were encountered in six of six animals. PTFE-wrapped IMAs were easily identified by appearance and by palpation. There was no adherence between PTFE membranes and surrounding tissue, nor was there evidence of cellular infiltration, disruption, or contraction of the membrane. Most notably, PTFE membranes could not be cut or injured with the electrocautery, since they are electrical nonconductors. This study demonstrates that PTFE membrane: (1) is relatively inert and incites minimal surrounding tissue reaction; and (2) is impenetrable to electrocautery injury. Further studies are necessary to determine the impact of PTFE membrane on IMA graft patency and wound infection. PTFE membrane may prove clinically useful in protecting patent IMA pedicles during reoperative cardiac surgery.

Original languageEnglish (US)
Pages (from-to)650-655
Number of pages6
JournalJournal of Cardiac Surgery
Volume8
Issue number6
StatePublished - 1993

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Mammary Arteries
Polytetrafluoroethylene
Membranes
Transplants
Electrocoagulation
Sternotomy
Wounds and Injuries
Palpation
Pericardium
Thoracic Wall
Wound Infection
Heart Arrest
Reoperation
Coronary Artery Bypass
Thoracic Surgery
Myocardium
Swine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Zehr, K. J., Lee, P. C., Poston, R. S., Gillinov, A. M., Hruban, R. H., & Cameron, D. E. (1993). Protection of the internal mammary artery pedicle with polytetrafluoroethylene membrane. Journal of Cardiac Surgery, 8(6), 650-655.

Protection of the internal mammary artery pedicle with polytetrafluoroethylene membrane. / Zehr, Kenton J; Lee, P. C.; Poston, R. S.; Gillinov, A. M.; Hruban, Ralph H; Cameron, D. E.

In: Journal of Cardiac Surgery, Vol. 8, No. 6, 1993, p. 650-655.

Research output: Contribution to journalArticle

Zehr, KJ, Lee, PC, Poston, RS, Gillinov, AM, Hruban, RH & Cameron, DE 1993, 'Protection of the internal mammary artery pedicle with polytetrafluoroethylene membrane', Journal of Cardiac Surgery, vol. 8, no. 6, pp. 650-655.
Zehr, Kenton J ; Lee, P. C. ; Poston, R. S. ; Gillinov, A. M. ; Hruban, Ralph H ; Cameron, D. E. / Protection of the internal mammary artery pedicle with polytetrafluoroethylene membrane. In: Journal of Cardiac Surgery. 1993 ; Vol. 8, No. 6. pp. 650-655.
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