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.