Use of MPH hemostatic powder for electrophysiology device implantation reduces postoperative rates of pocket hematoma and infection

Olga Reynbakh, Philippe Akhrass, Nektarios Souvaliotis, Chaithanya K. Pamidimukala, Hasnun Nahar, Joseph Bastawrose, Pierre Boktor, Joshua E. Aziz, Davendra Mehta, Emad F. Aziz

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Surgical site bleeding and infection are potential complications after electrophysiology (EP) device implantation procedures. To date, there is a wide variety of tools for management of intraoperative bleeding but it still remains unclear what methods are preferred. Objective: The aim of our study is to compare the rate of complications in patients who underwent cardiac implantable electronic device (CIED) implantation utilizing MPH hemostatic powder to the rate of complications in those patients who underwent standard procedure protocol without MPH hemostatic powder. Methods: In our study, a new plant-derived microporous polysaccharide hemostatic powder (Arista) was used. A total of 283 consecutive patients were retrospectively studied to assess the rate of complications in patients who underwent CIED implantation with MPH hemostatic powder (n = 77, MPH hemostatic powder) and without (n = 206, no MPH hemostatic powder). Patients were followed for 12 months. Results: The MPH hemostatic powder group of patients had a lower complication rate when compared to no MPH hemostatic powder, 0.3% vs. 1.7% (p <.05), respectively. The rate of device implantation site MPH hematoma in the MPH hemostatic powder group was 0.4%, versus 0.9% in the other group. There were no postoperative infections in the MPH hemostatic powder group versus 3.2% infections in the other group. The main predictor of increased risk of post-procedural complication was the usage of anticoagulation with a hazard ration of 2.7. Conclusion: Using MPH hemostatic powder for post-procedural hemostasis was shown to result in a significant reduction in the rate of overall post-procedural complications (a composite endpoint of hematoma and infections), and a trend in reduction of the infections rates and device implantation site hematoma rates.

Original languageEnglish
Pages (from-to)1861-1867
Number of pages7
JournalCurrent Medical Research and Opinion
Volume34
Issue number10
DOIs
StatePublished - 3 Oct 2018
Externally publishedYes

Keywords

  • Pocket hematoma
  • cardiac device infection
  • cardiac implantable electronic device
  • hemostatic agent

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