Experience with the use of polytetrafluoroethylene pericardial membrane (preclude pericardial membrane) for retroperitoneal closure after abdominal aortic surgery

Abstract

Objective: The purpose of the present publication is to assess the outcome after closure of the retroperitoneum with a patch of polytetrafluorethylene surgical membrane (Preclude Pericardial Membrane. PPM) after abdominal aortic surgery.

Experimental design: Retrospective review of 7 operated patients with a patch of PPM covering their abdominal aortic synthetic graft. Twenty-five months of follow up.

Setting: Institutional and University Hospital.

Patients and participants: Between June 1993 and February 1995, in 7 consecutive male patients (mean age 62 years) a patch of PPM was applied to their retroperitoneum after undergoing surgery in their infrarenal abdominal aorta. One patient had total obliteration of the distal abdominal aorta (Leriche syndrome) and the remaining 6 had a small infrarenal abdominal aortic aneurysm measuring in transverse diameter between 4 and 5 centimetres.

Interventions: The patient with Leriche Syndrome had an end to end aorto bifemoral bypass graft and the 6 cases with abdominal aortic aneurysm underwent resection of the aneurysm plus interposition of a straight vascular graft (3 cases), straight vascular graft and extension with other graft to the femoral artery (1 case) and bifurcated aorto-bifemoral graft (2 cases).

Measures: Clinical outcome and evolution of the patients, absence of complications derived from the PPM.

Results: There was no hospital mortality. All patients are alive after a mean follow-up of 25 months. Two patients were reoperated in the early postoperative period, one of them required a limited resection of the jejunum. There have been no complications related to the PPM.

Conclusions: In order to avoid secondary aorto-intestinal fistulas, in cases where complete coverage and isolation of an artificial vascular graft in the abdominal aorta can not be achieved, the use of a sheet of PPM separating the arterial graft from the gastrointestinal system may be an useful alternative.