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Journal of Cardiothoracic Surgery

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Open Access 01-12-2019 | Heart Surgery | Research article

Pericardial closure with extracellular matrix scaffold following cardiac surgery associated with a reduction of postoperative complications and 30-day hospital readmissions

Authors: Alfredo Rego, Patricia C. Cheung, William J. Harris, Kevin M. Brady, Jeffrey Newman, Robert Still

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Abstract

Background

A prospective, multi-center study (RECON) was conducted to evaluate the clinical outcomes of pericardial closure using a decellularized extracellular matrix (ECM) graft derived from porcine small intestinal submucosa.

Methods

Patients indicated for open cardiac surgery with pericardial closure using ECM were eligible for the RECON study cohort. Postoperative complications and readmission of the RECON patients were compared to the patient cohort in the Nationwide Readmissions Database (NRD). Inverse probability of treatment weighting was used to control the differences in patient demographics, comorbidities, and risk factors.

Results

A total of 1420 patients at 42 centers were enrolled, including 923 coronary artery bypass grafting (CABG) surgeries and 436 valve surgeries. Significantly fewer valve surgery patients in the RECON cohort experienced pleural effusion (3.1% vs. 13.0%; p < 0.05) and pericardial effusion (1.5% vs. 2.6%; p < 0.05) than in the NRD cohort. CABG patients in the RECON cohort were less likely to suffer bleeding (1.2% vs. 2.9%; p < 0.05) and pericardial effusion (0.2% vs. 2.2%, p < 0.05) than those in the NRD cohort. The 30-day all-cause hospital readmission rate was significantly lower among RECON patients than NRD patients following both valve surgery (HR: 0.34; p < 0.05) and CABG surgery (HR: 0.42; p < 0.05). In the RECON study, 14.4% of CABG patients and 27.0% of valve patients had postoperative atrial fibrillation as compared to previously reported risks, which generally ranges from 20 to 30% after CABG and from 35 to 50% after valve surgery.

Conclusions

Pericardial closure with ECM following cardiac surgery is associated with a reduction in the proportion of patients with pleural effusion, pericardial effusion, and 30-day readmission compared to a nationwide database.

Trial registration

NCT02073331, Registered on February 27, 2014.

Available only for authorised users

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Title: Pericardial closure with extracellular matrix scaffold following cardiac surgery associated with a reduction of postoperative complications and 30-day hospital readmissions
Authors: Alfredo Rego
Patricia C. Cheung
William J. Harris
Kevin M. Brady
Jeffrey Newman
Robert Still
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Heart Surgery
Pleural Effusion
Heart Surgery
Atrial Fibrillation
CABG
CABG
Published in: Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-019-0871-5

At a glance: The STEP trials

Springer Medicine

Pericardial closure with extracellular matrix scaffold following cardiac surgery associated with a reduction of postoperative complications and 30-day hospital readmissions

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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