BioGlue surgical adhesive for thoracic aortic repair during coagulopathy: efficacy and histopathology.
| Autor: | Hewitt CW; Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Cooper Hospital/University Medical Center, Camden, USA. chewitt@umdnj.edu, Marra SW, Kann BR, Tran HS, Puc MM, Chrzanowski FA Jr, Tran JL, Lenz SD, Cilley JH Jr, Simonetti VA, DelRossi AJ |
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| Jazyk: | angličtina |
| Zdroj: | The Annals of thoracic surgery [Ann Thorac Surg] 2001 May; Vol. 71 (5), pp. 1609-12. |
| DOI: | 10.1016/s0003-4975(01)02424-9 |
| Abstrakt: | 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 1,497 +/- 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. |
| Databáze: | MEDLINE |
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