EXPERIENCE WITH THE USE OF POLYTETRAFLUOROETHYLENE PERICARDIAL MEMBRANE (PRECLUDE PERICARDIAL MEMBRANE) FOR RETROPERITONEAL CLOSURE AFTER ABDOMINAL AORTIC-SURGERY

Objective. The purpose of the present publication is to assess the out come after closure of the retroperitoneum with a patch of polytetraflu orethylene surgical membrane (Preclude Pericardial Membrane. PPM) afte r abdominal aortic surgery. Experimental design. Retrospective review of 7 operated patients with a patch of PPM covering their abdominal ao rtic synthetic graft. Twenty-five months of follow up. Setting. Instit utional and University Hospital. Patients and participants. Between Ju ne 1993 and February 1995, in 7 consecutive male patients (mean age 62 years) a patch of PPM was applied to their retroperitoneum after unde rgoing surgery in their infrarenal abdominal aorta. One patient had to tal obliteration of the distal abdominal aorta (Leriche syndrome) and the remaining 6 had a small infrarenal abdominal aortic aneurysm measu ring in trasverse diameter between 4 and 5 centimetres. Interventions. The patient with Leriche Syndrome had an end to end aorto bifemoral b ypass graft and the 6 cases with abdominal aortic aneurysm underwent r esection of the aneurysm plus interposition of a straight vascular gra ft (3 cases), straight vascular graft and extension with other graft t o the femoral artery (1 case) and bifurcated aorto-bifemoral graft (2 cases). Measures. Clinical outcome and evolution of the patients, abse nce of complications derived from the PPM. Results. There was no hospi tal mortality. All patients are alive after a mean follow-up of 25 mon ths. Two patients were reoperated in the early postoperative period, o ne of them required a limited resection of the jejunum, There have bee n no complications related to the PPM. Conclusions. In order to avoid secondary aorto-intestinal fistulas, in cases where complete coverage and isolation of an artificial vascular graft in the abdominal aorta c an not be achieved, the use of a sheet of PPM separating the arterial graft from the gastrointestinal system may be an useful alternative.