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Head WT, Paladugu N, Kwon JH, et al. Adhesion barriers in cardiac surgery: A systematic review of efficacy. J Card Surg. 2021;37(1):176-185doi: 10.1111/jocs.16062.
Head, W. T., Paladugu, N., Kwon, J. H., Gerry, B., Hill, M. A., Brennan, E. A., Kavarana, M. N., & Rajab, T. K. (2022). Adhesion barriers in cardiac surgery: A systematic review of efficacy. Journal of cardiac surgery, 37(1), 176-185. https://doi.org/10.1111/jocs.16062
Head, William T, et al. "Adhesion barriers in cardiac surgery: A systematic review of efficacy." Journal of cardiac surgery vol. 37,1 (2022): 176-185. doi: https://doi.org/10.1111/jocs.16062
Head WT, Paladugu N, Kwon JH, Gerry B, Hill MA, Brennan EA, Kavarana MN, Rajab TK. Adhesion barriers in cardiac surgery: A systematic review of efficacy. J Card Surg. 2022 Jan;37(1):176-185. doi: 10.1111/jocs.16062. Epub 2021 Oct 17. PMID: 34661944.
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J Card Surg. 2022 Jan;37(1):176-185. doi: 10.1111/jocs.16062. Epub 2021 Oct 17.

Adhesion barriers in cardiac surgery: A systematic review of efficacy.

Journal of cardiac surgery

William T Head, Namrata Paladugu, Jennie H Kwon, Brielle Gerry, Morgan A Hill, Emily A Brennan, Minoo N Kavarana, Taufiek K Rajab

Affiliations

  1. Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
  2. Department of Research & Education Services (Libraries), Medical University of South Carolina, Charleston, South Carolina, USA.

PMID: 34661944 DOI: 10.1111/jocs.16062

Abstract

BACKGROUND: Postoperative pericardial adhesions have been associated with increased morbidity, mortality, and surgical difficulty. Barriers exist to limit adhesion formation, yet little is known about their use in cardiac surgery. The study presented here provides the first major systematic review of adhesion barriers in cardiac surgery.

METHODS: Scopus and PubMed were assessed on November 20, 2020. Inclusion criteria were clinical studies on human subjects, and exclusion criteria were studies not published in English and case reports. Risk of bias was evaluated with the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with Excel and GraphPad Prism 5.

RESULTS: Twenty-five studies were identified with a total of 13 barriers and 2928 patients. Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier (13 studies, 67% of patients) with adhesion formation rate of 37.31% and standardized tenacity score of 26.50. Several barriers had improved efficacy. In particular, Cova CARD had a standardized tenacity score of 15.00.

CONCLUSIONS: Overall, the data varied considerably in terms of study design and reporting bias. The amount of data was also limited for the non-PTFE studies. PTFE has historically been effective in preventing adhesions. More recent barriers may be superior, yet the current data is nonconfirmatory. No ideal adhesion barrier currently exists, and future barriers must focus on the requirements unique to operating in and around the heart.

© 2021 Wiley Periodicals LLC.

Keywords: adhesion; adhesion barrier; cardiac surgery; clinical review; pericardial adhesions; systematic review

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