BioGlue surgical adhesive for thoracic aortic repair during coagulopathy: Efficacy and histopathology

被引:79
作者
Hewitt, CW
Marra, SW
Kann, BR
Tran, HS
Puc, MM
Chrzanowski, FA
Tran, JLV
Lenz, SD
Cilley, JH
Simonetti, VA
DelRossi, AJ
机构
[1] Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Cooper Hosp Univ Med Ctr, Dept Surg, Camden, NJ 08103 USA
[2] Auburn Univ, Coll Vet Med, Dept Pathobiol, Auburn, AL 36849 USA
关键词
D O I
10.1016/S0003-4975(01)02424-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. We hypothesized that induction of coagulopathy in sheep would model clinical needle hole and surgical bleeding from synthetic graft anastomoses, and that a new tissue bioadhesive (BioGlue) would control postoperative blood loss during surgical repair of the thoracic aorta. Methods. Sheep were anticoagulated with aspirin and heparin. A bypass was made using end-to-side anastomoses of a graft to a partially occluded descending thoracic aorta. Experimental anastomoses (EXP, n = 9) were treated with BioGlue, and control anastomoses (CON, n = 5) were treated with Surgicel to gain intraoperative hemostasis. Results. EXP animals exhibited significantly reduced postsurgical bleeding; (CON median 955 mL versus EXP median 470 mL, p < 0.003), a reduced rate of blood loss over the first 2 postoperative hours (CON median 210 mL/hr versus EXP median 92.5 mL/hr, p < 0.006), and over the entire recovery period (CON median 158 mL/hr versus EXP median 86 mL/hr, p < 0.05), and reduced total blood loss (CON mean 1497 +/- 691 mL versus EXP mean 668 +/- 285 mL, p < 0.008). On histologic examination of tissues explanted after 3 months, BioGlue was relatively inert and demonstrated a minimal inflammatory response. Conclusions. The use of BioGlue significantly reduced the volume and rate of postsurgical bleeding in a coagulopathic sheep model for thoracic aortic operations. Histopathologically, BioGlue generated only a minimal inflammatory response. This new surgical tissue bioadhesive should prove extremely beneficial for coagulopathic patients undergoing thoracic aortic or vascular procedures. (Ann Thorac Surg 2001;71:1609-12) (C) 2001 by The Society of Thoracic Surgeons.
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收藏
页码:1609 / 1612
页数:4
相关论文
共 16 条
[1]  
Bachet J, 1998, Chirurgie, V123, P229, DOI 10.1016/S0001-4001(98)80114-1
[2]  
Cohen J R, 1987, Ann Vasc Surg, V1, P552, DOI 10.1016/S0890-5096(06)61439-8
[3]   THORACOABDOMINAL AORTIC-ANEURYSMS - PREOPERATIVE AND INTRAOPERATIVE FACTORS DETERMINING IMMEDIATE AND LONG-TERM RESULTS OF OPERATIONS IN 605 PATIENTS [J].
CRAWFORD, ES ;
CRAWFORD, JL ;
SAFI, HJ ;
COSELLI, JS ;
HESS, KR ;
BROOKS, B ;
NORTON, HJ ;
GLAESER, DH .
JOURNAL OF VASCULAR SURGERY, 1986, 3 (03) :389-404
[4]  
*CRYOL INC, 1998, BIOGLUER PROD INF
[5]  
DELROSSI AJ, 1990, SURGERY, V108, P864
[6]   FORMALDEHYDE-FREE COLLAGEN GLUE IN EXPERIMENTAL LUNG GLUING [J].
ENNKER, IC ;
ENNKER, J ;
SCHOON, D ;
SCHOON, HA ;
RIMPLER, M ;
HETZER, R .
ANNALS OF THORACIC SURGERY, 1994, 57 (06) :1622-1627
[7]   The use of gelatin-resorcin-formalin glue in acute aortic dissection type A [J].
Fukunaga, S ;
Karck, M ;
Harringer, W ;
Cremer, J ;
Rhein, C ;
Haverich, A .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1999, 15 (05) :564-569
[8]   CLINICAL-EXPERIENCE WITH FIBRIN GLUE IN CARDIAC-SURGERY [J].
KOVEKER, G ;
DEVIVIE, ER ;
HELLBERG, KD .
THORACIC AND CARDIOVASCULAR SURGEON, 1981, 29 (05) :287-289
[9]  
MESSINA LM, 1994, SURG CRITICAL CARE, P291
[10]   Different techniques of distal aortic repair in acute type A dissection:: impact on late aortic morphology and reoperation [J].
Nguyen, B ;
Müller, M ;
Kipfer, B ;
Berdat, P ;
Walpoth, B ;
Althaus, U ;
Carrel, T .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1999, 15 (04) :496-500