© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.
Prevention of pocket related complications with fibrin sealant in patients undergoing pacemaker implantation who are receiving anticoagulant treatment
aVascular Department, Surgical clinic Clinical Center Nis Bulevar Zorana Djindjica 48, Bulevar Nemanjica 72a/25, 18 000 Nis, Serbia, Serbia and Montenegro; bClinic of Cardiovascular Diseases (Pacemaker Center) Clinical Center Nis Bulevar Zorana Djindjica 48, 18 000 Nis, Serbia, Serbia and Montenegro; cInstitute for Blood Transfusion, Nis Bulevar Zorana Djindjica 48, 18 000 Nis, Serbia, Serbia and Montenegro
AIM: The aim of our study was to establish the efficiency of fibrin sealant in the prevention of pocket related complications in patients undergoing pacemaker implantation who are receiving anticoagulant treatment.
METHODS: The study was performed on 40 and 41 patients prospectively randomized into treatment and control groups who underwent pacemaker implantation procedure between January 2002 and July 2004 at the Pacemaker Center – Clinical Centre Nis, Serbia. Both groups of patients were receiving anticoagulant treatment with either heparin or warfarin. Surgical procedures between the groups differed only in the application of fibrin sealant prior to wound closure in the treatment group.
RESULTS: In the treatment group, there were no pocket related complications while in the control group six patients (14.63%) had minor haematomas that required no treatment. Four patients (9.76%) had significant haematomas (two patients were treated conservatively while the other two needed reintervention). The INR in the treatment group was 2.76 ± 0.85 and in the control group 2.65 ± 0.79 (P = ns). In the follow-up period (2–27 months) no late complications were registered in either group.
CONCLUSION: Fibrin sealant is an effective haemostatic agent. The results obtained in our study show that the administration of fibrin sealant in patients receiving anticoagulant treatment eliminates postoperative haematomas after pacemaker implantation.
Key Words: fibrin sealant, pacemaker implantation, complications, pocket haematoma
*Corresponding author. Tel.: +381 18 323 979; fax: +381 18 531 950. E-mail addressess: antimon{at}eunet.yu, dmilic{at}ptt.yu (D.J. Milic).
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