The Effect of Mitomycin-C in Reducing Pericardial Adhesion After Cardiac Surgery in Rabbits

Background: Mitomycin-C has been in clinical use primarily as a chemotherapeutic agent and is well known for antifibrotic properties. It has been widely used to prevent postoperative fibroblast proliferation and reduce scar adhesion in ophthalmologic and otolaryngologic operations. We investigated the efficacy of mitomycin-C in reducing postoperative pericardial adhesions in a rabbit model. Methods: New Zealand white rabbits were used and categorized into 2 groups, study (use of mitomycin-C) and control. Group 1 (n = 8) was treated with a sponge impregnated with mitomycin-C solution that was applied over the abraded epicardium. In group 2 (control group), the sponge was impregnated with 0.9% isotonic NaCl solution and was applied with the same protocol as the mitomycin-C-impregnated sponge in group 1 (n = 8). Rabbits were humanely killed at a mean of 2 weeks. The scores of adhesion were graded by macroscopic examination, and the pericardial tissues were analyzed microscopically in terms of inflammation and fibrosis. Results: In group 1, the adhesion scores were significantly lower than the control group's. No significant difference was found between the groups in terms of the severity of inflammation. There was a difference between groups in terms of the degree of fibrosis. Conclusions: The use of mitomycin-C to prevent postoperative pericardial adhesions reduced adhesion and fibrosis scores in an experimental rabbit model. However, efficacy in reducing inflammation was not demonstrated.