Experimental use of an elastomeric surgical sealant for arterial hemostasis and its long-term tissue response.
ABSTRACT Reliable suture line hemostasis should improve the outcome of aortic surgery. We examined the hemostatic effect and the tissue response of a novel elastomeric surgical sealant.
Using porcine internal carotid arteries, we performed 16 end-to-end anastomoses with four stitches of simple interrupted sutures under full heparinization. The anastomoses were divided into two groups (eight anastomoses per group). Either novel sealant or fibrin glue was applied. The amount of bleeding was measured during the 30 s period after removing the vascular clamp. In a separate experiment, we applied the novel sealant around the abdominal aorta of rabbits (n=6) to assess the effect of the elastomeric property of the sealant on arterial wall histology. For comparison, we applied cyanoacrylate, which has no elastomeric property (n=6). A histological study was performed three months after the operation.
The novel sealant prevented arterial bleeding. The amount of bleeding from the anastomoses applied with novel sealant and fibrin glue was 0.12+/-0.03 g vs. 91.8+/-16.5 g, respectively (P<0.001). Thinning of the rabbit aortic wall was observed in the cyanoacrylate-treated abdominal aorta, whereas no thinning was observed in the novel sealant group. Histological examination revealed neither cell death nor necrosis in the novel sealant group.
The novel sealant effectively prevented arterial bleeding from the anastomosis under full heparinization. In addition, the elastomeric property of the sealant prevented thinning of the aortic wall. The novel sealant may be a promising hemostatic agent for arterial anastomosis.
- SourceAvailable from: Kozaburo HayashiASAIO transactions / American Society for Artificial Internal Organs 02/1986; 32(1):151-6.
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ABSTRACT: In cardiovascular surgery, the manual continuous suture has often been used for microvascular anastomosis, but the luminal irregularity often causes thrombotic stenosis in the anastomosis sites. The purpose of this study was to examine the feasibility of the combined use of gelatin-resorcin-formaldehyde (GRF) glue and a collagen sheet for the anastomosis of small arteries 3 to 4 mm in diameter in experimental animals. End-to-end anastomoses of the carotid and femoral arteries of mongrel dogs were carried out with the combined use of GRF glue and collagen sheet. The physical strength of the anastomosis, the histopathologic condition of the vassels, and the absorptivity and the inflammatory response of the glue were evaluated. The physical strength of the anastomosis sites was good and their flexibility optimal, the smooth luminal surface appeared excellent for preventing thrombotic stenosis in all follow-up periods, and the glue was absorbed almost completely within 12 weeks postoperatively. The combined use of GRF glue and collagen sheet would be feasible for the anastomosis of small arteries 3 to 4 mm in diameter and could substitute for the conventional suture method.Artificial Organs 05/2001; 25(4):281-91. · 1.96 Impact Factor
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ABSTRACT: The recent emergence of BioGlue Surgical Adhesive has widened the field of surgical adhesives for the cardiac surgeon. We believe the present series, in a wider spectrum of cardiac conditions, is the first larger scale evaluation of the use of this new adhesive. BioGlue was used in 115 consecutive patients (90 male and 25 female, age range 5 days to 87 years) from September 9, 1998 to March 12, 2001. Preoperative, intraoperative, and postoperative data were examined to establish its use, indications, and outcomes in patients undergoing cardiac surgical procedures. The most common underlying pathologic conditions were aortic dissections (30 patients) and aortic aneurysms (39 patients). The procedures carried out were aortic root replacement (36 patients), aortic wall replacement (39), ascending aorta repair (2), coronary artery bypass grafting (28), valve procedures (11), ventricular aneurysm repair (6), repair of postinfarct ventricular septal defect (2), and correction of congenital conditions (13 patients). The indications for BioGlue use were hemostasis in 79 patients, tissue adherence in 21, and tissue strengthening in 30. The hospital mortality was 10.1% (11 patients). Only 1 patient required a late reoperation for dehiscence of a suture line with formation of a false aneurysm. The mean postoperative blood loss at 12 hours was 702 mL. Ten patients developed a cerebrovascular accident postoperatively, which was considered to be unrelated to the use of BioGlue. All surgeons in this study believed that BioGlue facilitated the operation. Future follow-up of patients is required to validate our early promising results and to assess the long-term outcome of patients treated with BioGlue.The Annals of Thoracic Surgery 09/2002; 74(2):432-7. · 3.45 Impact Factor