Thorac Cardiovasc Surg 2011; 59(1): 40-44
DOI: 10.1055/s-0030-1250499
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Biological Materials for Diaphragmatic Repair: Initial Experiences with the PeriGuard Repair Patch®

P. Zardo1 , R. Zhang2 , B. Wiegmann2 , A. Haverich2 , S. Fischer1
  • 1Department of Thoracic Surgery and Lung Assist, Klinikum Ibbenbüren, Ibbenbüren, Germany
  • 2Department of Cardiothoracic, Transplantation and Vascular Surgery, Medizinische Hochschule Hannover, Hannover, Germany
Further Information

Publication History

received August 23, 2010

Publication Date:
17 January 2011 (online)

Abstract

Background: We sought to analyze the efficacy of a bovine pericardial patch (PeriGuard®) for diaphragmatic repair. Methods: Seven consecutive patients (6 males, median age 56 years) scheduled for diaphragmatic resection and/or repair were enrolled in this study. In all cases diaphragmatic repair was performed with a PeriGuard Repair Patch® (Synovis, St. Paul, MN, USA). At follow-up (median: 12 months; range: 6–18 months), quality of life, signs of reherniation and incorporation of mesh were assessed through clinical examination, blood samples and CT or MRT scan. Results: Diagnosis on admission included sarcoma (n = 2), mesothelioma (n = 1), squamous cell carcinoma (n = 1), parachordoma (n = 1) and large congenital or posttraumatic herniation (n = 2). At follow-up successful diaphragmatic repair with no signs of reherniation, graft dehiscence or seroma formation was confirmed for all patients. Recorded inflammatory markers [C-reactive protein (CRP), white blood cell count (WBC) and procalcitonin (PCT)] reached their peak values between postoperative day (POD) 4 and POD 7. Values ranged from 122–282 mg/L for CRP, 0.4–4.6 µg/L for PCT and 6.2–15.6 Tsd/µL for WBC. Overall oncological results were good and 5 out of 6 survivors reported a fully reestablished quality of life. Conclusion: We consider the PeriGuard Repair Patch® a viable alternative to synthetic materials for diaphragm replacement. Moreover, we advise carrying out cautious follow-up in patients undergoing extensive oncological resection to learn more about the biological behavior of the bovine PeriGuard Repair Patch® after diaphragmatic repair.

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Patrick Zardo, MD

Department of Thoracic Surgery and Lung Assist
Klinikum Ibbenbüren

Große Straße 41

49477 Ibbenbüren

Germany

Phone: +49 54 51 52 20 11

Fax: +49 54 51 52 50 59

Email: p.zardo@klinikum-ibbenbueren.de