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J Thorac Cardiovasc Surg 1996;112:248-252
© 1996 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

RIFAMPICIN ANTIBIOTIC IMPREGNATION OF THE ST. JUDE MEDICAL MECHANICAL VALVE SEWING RING: A WEAPON AGAINST ENDOCARDITIS

From the Departments of Cardiac Surgery and Microbiology, The Prince Charles Hospital, Brisbane, Australia.

Received for publication April 20, 1995 Revisions requested June 6, 1995; revisions received Oct. 20, 1995 Accepted for publication Oct. 27, 1995. Address for reprints: Mark O'Brien, FRCS, FRACS, Cardiac Surgeon-in-charge, Department of Cardiac Surgery, The Prince Charles Hospital, Rode Rd., Chermside, Queensland, Australia 4032.

Abstract

The Dacron sewing ring material of the St. Jude Medical mechanical heart valve (St. Jude Medical, Inc., St. Paul, Minn.) was passively impregnated with rifampicin (60 mg/ml) both in its unsealed state and after sealing by the methods of preclotting in blood, autoclaving in blood, and autoclaving in 20% albumin. Antistaphylococcal activity in the Dacron material was assessed immediately after rifampicin impregnation and at regular periods up to 5 days after implantation into the goat aorta. When the Dacron material had been sealed by autoclaving in blood and autoclaving in 20% albumin significant retention of antistaphylococcal activity was found after 5 days in vivo. Best results were obtained with the use of autoclaved blood (p < 0.05). We also compared these results with those obtained from impregnating commercially available gelatin-sealed (Gelseal) and collagen-sealed (Hemashield) Dacron material with rifampicin. Although antistaphylococcal activity was equivalent immediately after rifampicin impregnation, after 4 days in vivo the activity was negligible in Gelseal material (p < 0.05) and could not be demonstrated in Hemashield material. Rifampicin impregnation of the intact St. Jude Medical mechanical valve sewing ring may have an application in the prevention of prosthetic valve endocarditis and a clinical protocol is suggested. (J THORACCARDIOVASCSURG1996;112:248-52)

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