Novel hemostatic patch achieves sutureless epicardial wound closure during complex cardiac surgery, a case report

Abstract

Treatment of damaged cardiac tissue in patients with high bleeding tendency can be very challenging, damaged myocardial tissue has a high rupture risk when being sutured subsequently on-going bleeding is a major risk factor for poor clinical outcome. We present a case demonstrating the feasibility in using a novel haemostatic collagen sponge for the management of a myocardial wound. This report is the first description in cardiac surgery where Hemopatch sponges are used to successfully seal a left ventricle wound. Our patient was diagnosed with endocarditis, had a low pre-operative haemoglobin count and underwent cardiac surgery for multiple valve repairs. The procedure was performed on cardiopulmonary bypass, which meant our patient had to be heparinized. Despite these major risk factors for bleeding Hemopatch managed to contain bleeding and seal the wound, no sutures were needed.

Figures

Figure 1

Sutureless epicardial wound closure with Hemopatch. A. Epicardial exposure of the anterolateral coronary artery (arrow). B. Wound area is covered with Hemopatch just beneath the venous anastomosis (arrow). C. A second Hemopatch is positioned around the venous anastomosis, with hemostasis achieved while the coronary flow is established. Full flow can be seen in the venous anastomosis (compare with B, where it is flaccid).