Fate of fibrin sealant in pericardial space

Background. Although fibrin sealant (Beriplast, Aventis Behring, Marburg, G ermany) has been widely used as a supplementary measure for hemostasis duri ng cardiac surgery in Europe and is becoming popular in the United States, the pharmacokinetics of fibrin sealant applied in pericardial space has not been elucidated. Methods. A small incision was made on the epicardial surface of the left ve ntricle of a rat, and the incision was sutured. Total 0.2 mi of fibrin seal ant containing iodine 125 (I-125)-labeled fibrinogen, aprotinin, blood coag ulation factor XIII and thrombin was applied to the area around the suture line. Results. Distributions of I-125-labeled fibrinogen in the heart on postoper ative days 1, 3, 7, and 14 were 48.2% +/- 1.8%, 20.7% +/- 2.2%, 0.15% +/- 0 .02%, and 0.01% +/- 0.02%, respectively. The radioactivity was negligible i n the blood, liver, spleen, and kidney except for the thyroid in which the radioactivity increased to 7.9% +/- 0.7% and 4.3% +/- 0.4%, respectively, o n postoperative days 7 and 14. Iodine 125-labeled fibrinogen concentrations of the heart and other organs showed a similar change in the time course o f distribution. Dense and thick fibrin network, observed on postoperative d ay 1, had dissipated and was thinner with collagen formation by postoperati ve day 7. Conclusions. Fibrin sealant applied to the pericardial cavity regresses rap idly and plays an important role in wound healing. (Ann Thorac Surg 2000;70 :2132-6) (C) 2000 by The Society of Thoracic Surgeons.