HEPARINIZATION ON PERICARDIAL SUBSTITUTES CAN REDUCE ADHESION AND EPICARDIAL INFLAMMATION IN THE DOG

Objective: Primary concerns about currently available pericardial subs titutes include adhesion and epicardial reaction. The purpose of this study is to evaluate host reaction to pericardial substitutes with and without incorporating slow heparin release. Methods: To avoid biologi c variation among these pericardial patches, we made a composite of si x membranes. The composite membrane consisted of epoxy-fixed patches w ith (1) or without (2) ionically bound heparin, a glutaraldehyde-fixed patch with (3) or without (4) ionically bound heparin, an expanded po lytetrafluoroethylene patch (5), and a polyester polymeric patch (6). Ten recipient dogs weighing from 12 to 19 kg (mean 13.6 kg) were used to assess the composite membranes as pericardial substitutes. The impl anted composite membranes were retrieved 1 week (one dog), 2 weeks (on e dog), 4 weeks (one dog), 8 weeks (one dog), and 12 weeks (six dogs) after implantation. Results: Overall, the synthetic patches had a more notable inflammatory reaction than the biologic patches with or witho ut ionically bound heparin. The heparin-bound patches caused significa ntly less inflammation than their nonheparinized counterparts. The hep arinized porcine patches crosslinked with different compounds were fou nd to have less fibrous formation than the nonheparinized patches and the synthetic patches. Conclusions: Heparinized pericardial substitute s may cause less adhesion and inflammatory reaction than nonheparinize d material.