Interact CardioVasc Thorac Surg 2008;7:276-277. doi:10.1510/icvts.2007.169714A © 2008 European Association of Cardio-Thoracic Surgery
eComment: Foreign body reaction to polytetrafluoroethylene
Murat Ozeren
Mersin University Medical Faculty Department of Cardiovascular Surgery, Mersin 33079, Turkey
Entirely polytetrafluoroethylene coating for pacemaker system contact dermatitis
It is good to have a chance to reconsider usage of polytetrafluoroethylene (PTFE) surgical membrane [1]. The risk of injuring the heart, great vessels, or grafts during the reoperation continue to be a concern. Research for the ideal synthetic materials still continues. Tamenishi et al. are reporting contact dermatitis due to PTFE coating for pacemaker systems several months after implantation. Generally, it is concluded that the PTFE is safe and provides definite advantages during the reoperations. So, there are a limited number of papers against the usage of PTFE in the literature. I would like to emphasize our clinical experience for the usage of PTFE surgical membrane as a pericardial substitute [2].
PTFE surgical membrane (0.1 mm Gore-Tex Surgical membrane, WL Gore & Associates Inc., Flagstaff AZ) was used for the pericardial closure in 56 patients who were operated for mitral open commisuratomy. Seven patients were reoperated and we collected surgical and histological data of these cases. We found that PTFE surgical membrane provides small advantages because of dense adhesions and histological studies revealed two different characteristics, firstly PTFE appeared unchanged and there was no evidence of degeneration. Granulation and fibrous tissue was seen near the PTFE. Granulation tissue consists of diffuse foreign body reaction surrounded by multinuclear giant cells. Secondly, the PTFE appeared changed. Degeneration of PTFE membrane was seen as transparent and lytic in form. In my opinion, PTFE has some advantages but it is not an innocent prosthesis in spite of worldwide usage.
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References
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- Tamenishi A, Usui A, Oshima H, Ueda Y. Entirely polytetrafluoroethylene coating for pacemaker system contact dermatitis. Interact CardioVasc Thorac Surg 2008;7:275–277.[Abstract/Free Full Text]
- Ozeren M, Han U, Mavioglu I, Simsek E, Soyal M, Guler G, Yucel E. Consequences of PTFE membrane used for prevention of re-entry injuries in rheumatic valve disease. Cardiovasc Surg 2002;10:489–493.[CrossRef][Medline]
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Entirely polytetrafluoroethylene coating for pacemaker system contact dermatitis
- Akinori Tamenishi, Akihiko Usui, Hideki Oshima, and Yuichi Ueda
Interactive CardioVascular and Thoracic Surgery 2008 7: 275-277.
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