Creating an implantable device is a challenging engineering problem which, with time, usually yields to the engineer’s and scientist’s efforts. Getting one of these product on the market under time constraints can lead to trade offs and is always a delicate balance between the improvement of medical care and the profit motive. Finally approving one is clearly a great responsibility since it unleashes the product on the public. It’s interesting to note the clinical data on this product. Why would a membrane that presumably physically separates the pericardium from the chest wall produce only a 50% reduction in adhesions? Is it because of the mediastinitus it apparently causes?