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Vernile B, Feletti A. Wound complication associated with bovine serum albumin-glutaraldehyde ( BioGlue®) in ventricular neuroendoscopic surgery. Neurochirurgie 2023; 69:101486. [PMID: 37708576 DOI: 10.1016/j.neuchi.2023.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Bruno Vernile
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Italy.
| | - Alberto Feletti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Institute of Neurosurgery, University of Verona, Italy
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2
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Hamaguchi Y, Enomoto S, Kondo H, Tamura T. In vivo optical coherence tomography visualisation of coronary artery embolism caused by BioGlue in a middle-aged woman with Marfan syndrome who underwent the Bentall procedure: a case report. Eur Heart J Case Rep 2023; 7:ytad585. [PMID: 38046217 PMCID: PMC10689047 DOI: 10.1093/ehjcr/ytad585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/03/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
Background Coronary artery embolism caused by BioGlue is a rare complication; therefore, its diagnosis and treatment remain undefined. Case summary A 47-year-old woman underwent ascending aortic replacement and coronary artery bypass grafting (CABG) for type A acute aortic dissection involving the right coronary artery ostium in 2017. Subsequently, she was diagnosed with Marfan syndrome. Five years later in 2022, she underwent aortic arch replacement, the Bentall procedure, and repeat CABG because of aortic root enlargement and aortic regurgitation progression. Twelve days after surgery, coronary computed tomography angiography (CCTA) revealed left anterior descending (LAD) artery stenosis, whereas pre-operative CCTA was normal. On post-operative day 13, coronary angiography revealed 99% LAD artery stenosis. Intravascular ultrasound (IVUS) showed a non-echoic mass with clear margins, and optical coherence tomography (OCT) demonstrated a crystalloid mass. Both images suggested that the embolus was inorganic matter, suspected as being the surgical adhesive BioGlue. We could not remove the embolus by repeated thrombectomy; therefore, drug-eluting stent implantation was performed. Seven months after surgery, she had no symptoms, and CCTA confirmed stent patency. Discussion To our knowledge, this is the first case report to describe BioGlue embolism observed by OCT. We performed an in vitro study using a blood vessel model, and the obtained OCT image was very similar to the in vivo image. Although BioGlue embolism is a rare complication, it should be considered in cases of perioperative myocardial infarction of uncertain aetiology, and coronary imaging is useful for diagnosis.
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Affiliation(s)
- Yukihiro Hamaguchi
- Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan
| | - Soichiro Enomoto
- Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan
| | - Hirokazu Kondo
- Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan
| | - Toshihiro Tamura
- Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan
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Kitamura H, Tamaki M, Kawaguchi Y. Surgical glue-induced left main trunk stenosis removed by directional coronary atherectomy. Interact Cardiovasc Thorac Surg 2022; 34:162-164. [PMID: 34999798 PMCID: PMC8932500 DOI: 10.1093/icvts/ivab227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/17/2021] [Accepted: 07/15/2021] [Indexed: 11/14/2022] Open
Abstract
A 55-year-old man underwent aortic repair for acute aortic dissection. The pseudolumen of the Valsalva sinus was reapproximated with BioGlue by placing a sponge inside of it to prevent the BioGlue from entering. Postoperative contrast-enhanced computed tomography showed stenosis of the left main trunk. Directional coronary atherectomy was performed; complete release of the stenosis was achieved. Various fragments retrieved from the left main trunk were pathologically consistent with BioGlue. When we reapproximated the dissected aortic wall, inserting a sponge into the aorta did not prevent the surgical glue from entering. Directional coronary atherectomy was a good therapeutic option to treat glue-induced coronary artery stenosis.
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Affiliation(s)
- Hideki Kitamura
- Department of Cardiovascular Surgery, Nagoya Heart Center, Nagoya, Japan
| | - Mototsugu Tamaki
- Department of Cardiovascular Surgery, Nagoya Heart Center, Nagoya, Japan
| | - Yasuhiko Kawaguchi
- Department of Cardiovascular Surgery, Nagoya Heart Center, Nagoya, Japan
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4
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Tan SZCP, Bashir M. Prevention versus cure: Is BioGlue priming the optimal strategy against E-Vita NEO graft oozing? J Card Surg 2021; 37:555-560. [PMID: 34907587 DOI: 10.1111/jocs.16179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Since the introduction of the E-Vita Open NEO aortic prosthesis in 2020, several incidences of post-anastomotic oozing from the polyester portion of the graft have emerged. The use of BioGlue to prime E-Vita Open NEO to prevent this has been suggested as a way to mitigate this worrying complication. We investigate the extent of graft oozing in E-Vita Open NEO and evaluate the use of BioGlue in preventing oozing, both experimentally and in terms of potential clinical complications. MATERIALS AND METHODS E-Vita Open NEO (in straight and branched configurations) was implanted in a perfused model. The distal stent graft and side branches were clamped, and the graft was pressurized with blood to 120 mmHg. The volume of blood (ml) oozing from the graft within 60 s was measured. Nonpressurized grafts were coated with BioGlue up to a thickness of 1, 2, and 3 mm, and the volume (mm3 ) of BioGlue required to do so was recorded. RESULTS Within 60 s, 250.0 ml of blood oozed from the grafts tested. 43.694, 87.389, and 174.778 mm3 of BioGlue were required to coat the device with 1, 2, and 3 mm of BioGlue. CONCLUSION Graft oozing from E-Vita Open NEO represents an omnipresent and worrying risk. The use of BioGlue herein is likely associated with several adverse consequences, which are an additional risk on top of that posed by graft oozing. These risks call into question the suitability of E-Vita Open NEO, especially when compared to alternative devices not affected by oozing.
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Affiliation(s)
- Sven Z C P Tan
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mohamad Bashir
- Vascular and Endovascular Surgery, Velindre University NHS Trust, Health & Education Improvement, Wales, UK
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Yilmaz N, Sologashvili T, Huber C, Cikirikcioglu M. Sterile peri-graft abscess formation following aortic replacement: A word of caution for usage of BioGlue®. Int J Artif Organs 2021; 44:917-919. [PMID: 34496649 PMCID: PMC8559189 DOI: 10.1177/03913988211045091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report sterile peri-graft abscess formation following an ascending aortic and hemiarch
replacement for acute type A aortic dissection, possibly caused as a reaction to
BioGlue®. The patient was successfully treated by drainage, cleaning, removal
of BioGlue® remnants, three sessions of negative-pressure wound dressing, and
secondary chest closure.
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Affiliation(s)
- Nurcan Yilmaz
- Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tornike Sologashvili
- Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christoph Huber
- Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mustafa Cikirikcioglu
- Division of Cardiovascular Surgery, Department of Surgery, University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Yokoi M, Fujita H, Ogawa T, Ito T, Seo Y, Suda H, Ohte N. Intravascular Ultrasound Findings of BioGlue Surgical Adhesive Coronary Embolism After Ascending Aorta Replacement. JACC Cardiovasc Interv 2021; 14:e39-e41. [PMID: 33516693 DOI: 10.1016/j.jcin.2020.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Masashi Yokoi
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroshi Fujita
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Tatsuhito Ogawa
- Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tsuyoshi Ito
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hisao Suda
- Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Miyagi T, Ishimine T, Nakazato J, Taniguchi N, Yagi N, Takahashi T, Tengan T, Wake M. Coronary Artery Embolism Caused by BioGlue Surgical Adhesive After Type A Acute Aortic Dissection Repair. JACC Case Rep 2021; 3:53-57. [PMID: 34317468 PMCID: PMC8305680 DOI: 10.1016/j.jaccas.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/04/2020] [Accepted: 11/13/2020] [Indexed: 11/21/2022]
Abstract
Coronary artery embolism due to BioGlue surgical adhesive after repair of type A acute aortic dissection is a rare condition. We report a case of BioGlue coronary artery embolism after type A acute aortic dissection repair confirmed using intravascular ultrasound imaging and pathological examination. It was successfully treated with percutaneous coronary intervention. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Tadayoshi Miyagi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Tohru Ishimine
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Jun Nakazato
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Naoki Taniguchi
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Nobuhito Yagi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Takanori Takahashi
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Toshiho Tengan
- Division of Cardiovascular Surgery, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Minoru Wake
- Division of Cardiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
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Sugimoto K, Kadosaki M, Nakata S, Aizawa K, Kawahito K, Takeuchi M. BioGlue® manifesting as a subaortic floating object seen during ventricular septal rupture surgery: a case report. JA Clin Rep 2020; 6:27. [PMID: 32291525 PMCID: PMC7156531 DOI: 10.1186/s40981-020-00332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kenzaburo Sugimoto
- Department of Anaesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan.
| | - Mamoru Kadosaki
- Department of Anaesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Sho Nakata
- Department of Anaesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Kei Aizawa
- Department of Surgery, Division of Cardiovascular Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Koji Kawahito
- Department of Surgery, Division of Cardiovascular Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Mamoru Takeuchi
- Department of Anaesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
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Slezak P, Klang A, Ferguson J, Monforte X, Schmidt P, Bauder B, Url A, Osuchowski M, Redl H, Spazierer D, Gulle H. Tissue reactions to polyethylene glycol and glutaraldehyde-based surgical sealants in a rabbit aorta model. J Biomater Appl 2020; 34:1330-1340. [PMID: 31959032 PMCID: PMC7088439 DOI: 10.1177/0885328219900078] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Paul Slezak
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology in AUVA Research Center, Vienna, Austria
| | - Andrea Klang
- University of Veterinary Medicine, Institute of Pathology, Vienna, Austria
| | - James Ferguson
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology in AUVA Research Center, Vienna, Austria
| | - Xavier Monforte
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology in AUVA Research Center, Vienna, Austria
| | - Peter Schmidt
- University of Veterinary Medicine, Institute of Pathology, Vienna, Austria
| | - Barbara Bauder
- University of Veterinary Medicine, Institute of Pathology, Vienna, Austria
| | - Angelika Url
- University of Veterinary Medicine, Institute of Pathology, Vienna, Austria
| | - Marcin Osuchowski
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology in AUVA Research Center, Vienna, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology in AUVA Research Center, Vienna, Austria
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Oria M, Duru S, Scorletti F, Vuletin F, Encinas JL, Correa-Martín L, Bakri K, Jones HN, Sanchez-Margallo FM, Peiro JL. Intracisternal BioGlue injection in the fetal lamb: a novel model for creation of obstructive congenital hydrocephalus without additional chemically induced neuroinflammation. J Neurosurg Pediatr 2019; 24:1-11. [PMID: 31561226 DOI: 10.3171/2019.6.peds19141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/10/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors hypothesized that new agents such as BioGlue would be as efficacious as kaolin in the induction of hydrocephalus in fetal sheep. METHODS This study was performed in 34 fetal lambs randomly divided into 2 studies. In the first study, fetuses received kaolin, BioGlue (2.0 mL), or Onyx injected into the cisterna magna, or no injection (control group) between E85 and E90. In the second study, fetuses received 2.0-mL or 2.5-mL injections of BioGlue into the cisterna magna between E85 and E90. Fetuses were monitored using ultrasound to assess lateral ventricle size and progression of hydrocephalus. The fetuses were delivered (E120-E125) and euthanized for histological analysis. Selected brain sections were stained for ionized calcium binding adaptor 1 (Iba1) and glial fibrillary acidic protein (GFAP) to assess the presence and activation of microglia and astroglia, respectively. Statistical comparisons were performed with Student's t-test for 2 determinations and ANOVA 1-way and 2-way repeated measures for multiple determinations. RESULTS At 30 days after injection, the lateral ventricles were larger in all 3 groups that had undergone injection than in controls (mean diameter in controls 3.76 ± 0.05 mm, n = 5). However, dilatation was greater in the fetuses injected with 2 mL of BioGlue (11.34 ± 4.76 mm, n = 11) than in those injected with kaolin (6.4 ± 0.98 mm, n = 7) or Onyx (5.7 ± 0.31 mm, n = 6) (ANOVA, *p ≤ 0.0001). Fetuses injected with 2.0 mL or 2.5 mL of BioGlue showed the same ventricle dilatation but it appeared earlier (at 10 days postinjection) in those injected with 2.5 mL. The critical threshold of ventricle dilatation was 0.1 for all the groups, and only the BioGlue 2.0 mL and BioGlue 2.5 mL groups exceeded this critical value (at 30 days and 18 days after injection, respectively) (ANOVA, *p ≤ 0.0001). Moderate to severe hydrocephalus with corpus callosum disruption was observed in all experimental groups. All experimental groups showed ventriculomegaly with significant microgliosis and astrogliosis in the subventricular zone around the lateral ventricles. Only kaolin resulted in significant microgliosis in the fourth ventricle area (ANOVA, *p ≤ 0.005). CONCLUSIONS The results of these studies demonstrate that BioGlue is more effective than Onyx or kaolin for inducing hydrocephalus in the fetal lamb and results in a volume-related response by obstructive space-occupancy without local neuroinflammatory reaction. This novel use of BioGlue generates a model with potential for new insights into hydrocephalus pathology and the development of therapeutics in obstructive hydrocephalus. In addition, this model allows for the study of acute and chronic obstructive hydrocephalus by using different BioGlue volumes for intracisternal injection.
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Affiliation(s)
- Marc Oria
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
| | - Soner Duru
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
| | - Federico Scorletti
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
- 3Department of Pediatric Surgery, Hospital Bambino Gesu, Rome, Italy
| | - Fernando Vuletin
- 4Department of Pediatric Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile; and
| | - Jose L Encinas
- 5Department of Pediatric Surgery, Hospital La Paz, Madrid, Spain
| | | | - Kenan Bakri
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
| | - Helen N Jones
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
| | | | - Jose L Peiro
- 1Center for Fetal and Placental Research, Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio
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Woo W, Hong S, Kim TH, Baek MY, Song SW. Delayed Pulmonary Artery Rupture after Using BioGlue in Cardiac Surgery. Korean J Thorac Cardiovasc Surg 2017; 50:474-476. [PMID: 29234619 PMCID: PMC5716655 DOI: 10.5090/kjtcs.2017.50.6.474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/22/2017] [Accepted: 02/27/2017] [Indexed: 11/29/2022]
Abstract
A 56-year-old woman, who underwent cardiac surgery 3 months previously, presented to the emergency room with pulmonary artery rupture due to the cytotoxic effects of BioGlue (CryoLife Inc., Kennesaw, GA, USA). She was successfully treated with surgical management. Although surgical glue can be effectively used for hemostasis, it can induce delayed vascular complications. Therefore, surgical glue should be used cautiously.
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Affiliation(s)
- Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Soonchang Hong
- Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine
| | - Tae-Hoon Kim
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Min-Young Baek
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Suk-Won Song
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine
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12
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Singh A, Wyatt M, Clarke M, Wales L. Late Sterile Abscess Formation in Carotid Endarterectomy Following Use of BioGlue: A Word of Caution. EJVES Short Rep 2017; 37:12-13. [PMID: 29234733 PMCID: PMC5684536 DOI: 10.1016/j.ejvssr.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/27/2017] [Accepted: 10/08/2017] [Indexed: 11/28/2022] Open
Abstract
Introduction BioGlue (CryoLife Inc., Kennesaw, GA) is a commonly used surgical adhesive, designed to achieve haemostasis following large vessel cardiovascular operations. Report An 88-year-old female presents with an enlarging right sided neck mass 9 months after carotid endarterectomy with bovine pericardial patch repair which utilised BioGlue seal the patch suture line. Conclusion BioGlue should be used properly and with caution. In cases of late wound complication following BioGlue use, simple drainage, debridement, and removal of BioGlue remnants may be a satisfactory approach.
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Affiliation(s)
- A Singh
- Northern Vascular Centre, Freeman Hospital, Newcastle, UK
| | - M Wyatt
- Northern Vascular Centre, Freeman Hospital, Newcastle, UK
| | - M Clarke
- Northern Vascular Centre, Freeman Hospital, Newcastle, UK
| | - L Wales
- Northern Vascular Centre, Freeman Hospital, Newcastle, UK
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13
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Bahouth Z, Halachmi S, Shprits S, Burbara Y, Avitan O, Masarwa I, Moskovitz B, Nativ O. The use of bovine serum albumin-glutaraldehyde tissue adhesive ( BioGlue®) for tumor bed closure following open partial nephrectomy. Actas Urol Esp 2017; 41:511-515. [PMID: 28283215 DOI: 10.1016/j.acuro.2016.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/16/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure in open nephron-sparing surgery (NSS). MATERIALS AND METHODS The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in-situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue® sealant for tumor bed filling, without suturing the edges. RESULTS Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2±1.6cm and mean R.E.N.A.L nephrometry score was 8.0±1.6. Mean ischemia time was 21.8±7.6. Mean estimated blood loss was 42±82ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (Δ=-1.7ml/min) was insignificant in a mean follow-up of 30.1±29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. CONCLUSIONS The use of BioGlue® alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.
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Tsilimigras DI, Antonopoulou A, Ntanasis-Stathopoulos I, Patrini D, Papagiannopoulos K, Lawrence D, Panagiotopoulos N. The role of BioGlue in thoracic surgery: a systematic review. J Thorac Dis 2017; 9:568-576. [PMID: 28449464 DOI: 10.21037/jtd.2017.02.57] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND BioGlue is a commonly used sealant in thoracic surgery. Prolonged air leak and presence of bronchopleural fistulae (BPF) are often encountered in clinical practice. We therefore, investigated the role and the efficacy of BioGlue in these scenarios. METHODS A systematic review was conducted by searching Medline [1966-2016] and Cochrane Central Register of Controlled Trials (CENTRAL) [1999-2016] along with reference lists of the included studies. Included studies reported on thoracic surgery operations and use of BioGlue in thoracic surgical procedures, whereas excluded studies met at least one of the following criteria: non-English language studies, non-human population, studies on surgical specialties other than Thoracic surgery, reviews and meta-analyses and sealants other than BioGlue. RESULTS Twelve studies with a total number of 194 patients were included. Amongst them, 178 were treated for alveolar air leaks (AAL), 14 for BPF and 2 for lymphatic leaks. BioGlue was utilized at the time of initial operation in 172 (96.7%) patients for AAL, while at secondary intervention in 13 (92.9%) for BPF and 1 (50%) for lymphatic leak. In terms of AAL, only 2 out of 4 studies showed statistically significant reduction in duration of air leak, duration of intercostal drainage and length of stay (LOS) when BioGlue was applied. No complications were encountered after using BioGlue in sealing BPF, apart from the re-application of BioGlue in 3 cases. CONCLUSIONS Although BioGlue has been shown to be efficient in treating AAL, it should be used with caution against BPF, despite encouraging preliminary results. Potential adverse effects must always be taken into consideration. Future randomized controlled trials are warranted in an attempt to establish its benefit in current clinical practice.
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Affiliation(s)
- Diamantis I Tsilimigras
- Department of Thoracic Surgery, University College London Hospitals (UCLH), London, UK.,School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aspasia Antonopoulou
- Department of Thoracic Surgery, University College London Hospitals (UCLH), London, UK.,School of Medicine, University of Patras, Patras, Greece
| | | | - Davide Patrini
- Department of Thoracic Surgery, University College London Hospitals (UCLH), London, UK
| | | | - David Lawrence
- Department of Thoracic Surgery, University College London Hospitals (UCLH), London, UK
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Bures M, Zardo P, Länger F, Zhang R. Improved application technique of albumin-glutaraldehyde glue for repair of superficial lung defects. J Cardiothorac Surg 2016; 11:149. [PMID: 27769306 PMCID: PMC5075190 DOI: 10.1186/s13019-016-0544-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background Albumin-glutaraldehyde glue has gained widespread acceptance for treatment of alveolar air leaks (AAL) in thoracic surgery. As liquid run-off during application is detrimental to its sealing efficacy, we developed a modified technique and assessed it in vitro. Methods Caudal lobes of freshly excised swine lungs (n = 20) were intubated and ventilated. A standardized focal superficial parenchymal defect (40 × 25 mm) was created on the inflated lung. AAL was assessed under exposure to increasing inspired tidal volume (TVi). Lung lobes were randomly selected and subjected to either a standard sealing suggested by the manufacturer (control group) or a modified technique relying on placement of a square silicone frame around the lesion site (study group). AAL was subsequently assessed until burst failure occurred and the occuring lesions length was recorded on the inflated lung to evaluate elasticity of underlying tissue. Results Superficial parenchymal defects resulted in AAL increasing with ascending TVi. AAL prior to sealant application was comparable in both groups. An application error occurred once in our control group. At TVi = 400, 500, 600 and 700 ml, the albumin-glutaraldehyde glue achieved complete sealing in 10, 10, 9 and 8 lungs respectively in our study group, as opposed to 9, 7, 6 and 4 lobes in the control group. The required mean burst pressure was significantly higher in our study group (41.0 ± 1.0 vs. 37.5 ± 4.2 cmH2O, p = 0.0195), but there was no difference in expansion of covered defect between both groups (1.0 ± 0.4 vs. 1.5 ± 1.7 mm, p = 0.3772). Conclusions Our tests suggest that frame-assisted sealant application might prevent glue run-off and thus improves its sealing efficacy. We encourage further investigation of this technique in well-designed, controlled clinical trials. Electronic supplementary material The online version of this article (doi:10.1186/s13019-016-0544-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maximilian Bures
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Patrick Zardo
- Department of Cardiac and Thoracic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Florian Länger
- Department of Pathology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Ruoyu Zhang
- Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Chest Hospital Schillerhoehe, Teaching hospital of the University of Tuebingen, Gerlingen, Germany. .,Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Solitudestr. 18, Gerlingen, Germany.
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Abstract
INTRODUCTION Advances in diagnostic imaging and monitoring have led to a shift towards primary non-operative management for most blunt liver injuries. Hemostatic biologic agents are a potential adjunct in the treatment of bile leak, especially in patients requiring surgery for drainage of a biloma. PRESENTATION OF CASE We present a 31year old woman who presented to the hospital after a motor vehicle accident. She was found to have a Grade 4 liver injury causing hemoperitoneum. The patient was taken immediately for an exploratory laparotomy where the laceration was packed with an absorbable hemostatic mesh. On clinic follow-up one week after discharge, the patient was found to have a bile leak. An ERCP was performed and a stent was placed over the location of the leak. The patient underwent laparotomy the following day for evacuation of her bilomas. The liver laceration was identified and remained at the same depth. CryoLife Bioglue was used to seal the laceration. DISCUSSION Given the high volume biloma, it is unlikely this patient would have been successfully treated without laparotomy. As such, this was an ideal opportunity to utilize Bioglue as an adjunct to seal the liver laceration, and thus potentially the area of bile extravasation. The diversion of drainage using ERCP was likely to have reduced the volume of bile leak substantially, which would also have helped increase the efficacy of the procedure. CONCLUSION The case presented demonstrates a novel and safe option for the delayed repair of traumatic lacerations.
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Affiliation(s)
- Edward Daniele
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79416, United States.
| | - Sharmila Dissanaike
- Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79416, United States
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17
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Bures M, Höffler HK, Friedel G, Kyriss T, Boedeker E, Länger F, Zardo P, Zhang R. Albumin-glutaraldehyde glue for repair of superficial lung defect: an in vitro experiment. J Cardiothorac Surg 2016; 11:63. [PMID: 27072534 PMCID: PMC4828862 DOI: 10.1186/s13019-016-0443-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 04/04/2016] [Indexed: 11/29/2022] Open
Abstract
Background Albumin-glutaraldehyde glue gained a widespread acceptance in repair of superficial lung defects associated with alveolar air leaks (AAL). As its sealing efficacy has not yet been thoroughly corroborated by clinical studies, we sought to assess the properties of commercially available albumin-glutaraldehyde glue (BioGlue™) in an in vitro lung model. Methods The lower lobe of freshly excised swine lung (n = 10) was intubated and ventilated. A focal superficial parenchymal defect (40 × 25 mm) was created on the inflated lung. AAL was assessed with increasing inspired tidal volume (TVi). After glue application, AAL was assessed until burst failure occurred. To evaluate glue elasticity, the length of defect was recorded in the inflated lung. Results Superficial parenchymal defects resulted in AAL increasing with ascending TVi. Multiple linear regression analysis revealed strong correlation between AAL and maximal inspiratory pressure. There was one application error. At TVi = 400, 500, 600, 700, 800 and 900 ml, BioGlue™ achieved complete sealing in nine, six, five, four two and one specimens, respectively. Mean burst pressure was 38.0 ± 4.2 cmH2O. All sealant failures were cohesive. BioGlue™ allowed an expansion of covered lung defects of 1.5 ± 1.7 mm. Conclusions Our in vitro tests demonstrated a high sealing efficacy of BioGlue™ for repair of superficial lung defects. Due to the rigid nature, caution should be taken to use this kind of sealant in trapped lungs.
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Affiliation(s)
- Maximilian Bures
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Hans-Klaus Höffler
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Godehard Friedel
- Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Teaching hospital of the University of Tuebingen, Solitudestr. 18, Gerlingen, Germany
| | - Thomas Kyriss
- Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Teaching hospital of the University of Tuebingen, Solitudestr. 18, Gerlingen, Germany
| | - Enole Boedeker
- Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Teaching hospital of the University of Tuebingen, Solitudestr. 18, Gerlingen, Germany
| | - Florian Länger
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Patrick Zardo
- Department of Cardiac and Thoracic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Ruoyu Zhang
- Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Teaching hospital of the University of Tuebingen, Solitudestr. 18, Gerlingen, Germany.
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Jordan MC, Schmitt V, Dannigkeit S, Schmidt K, Meffert RH, Hoelscher-Doht S. Surgical adhesive BioGlue™ does not benefit tendon repair strength: an ex vivo study. J Hand Surg Eur Vol 2015; 40:700-4. [PMID: 25588666 DOI: 10.1177/1753193414566566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 11/19/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Surgical adhesives are useful supplements in surgery, but their benefit in tendon repair is uncertain. The purpose of this study was to evaluate the effect of BioGlue™ on strength of flexor tendon repair. A total of 60 porcine flexor tendons were divided into three groups. In group one, a conventional core and peripheral suture repair was used. In group two, a core suture and BioGlue™ were used. In group three, a conventional core and peripheral suture repair and BioGlue™ were used. We performed static and cyclic axial load testing and measured diameter of the repair site. We found that BioGlue™ did not improve the tensile strength when added to a core and peripheral suture and that there was an increase in bulk at the repair site. We conclude that BioGlue™ application cannot replace a peripheral suture as tensile strength significantly decreases without a peripheral suture, and it does not benefit a tendon already repaired with a core and peripheral suture. LEVEL OF EVIDENCE n/a.
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Affiliation(s)
- M C Jordan
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
| | - V Schmitt
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
| | - S Dannigkeit
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
| | - K Schmidt
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
| | - R H Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
| | - S Hoelscher-Doht
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Clinics of Wuerzburg, Wuerzburg, Germany
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Vokrri L, Qavdarbasha A, Rudari H, Ahmetaj H, Manxhuka-Kërliu S, Hyseni N, Porcu P, Cinquin P, Sessa C. Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits. Vasc Health Risk Manag 2015; 11:211-7. [PMID: 25848302 PMCID: PMC4383148 DOI: 10.2147/vhrm.s73104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. METHODS Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment. RESULTS Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses. CONCLUSION This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.
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Affiliation(s)
- Lulzim Vokrri
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
- University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, France
| | - Arsim Qavdarbasha
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
| | - Hajriz Rudari
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
| | - Halil Ahmetaj
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
| | - Suzana Manxhuka-Kërliu
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
| | - Nexhmi Hyseni
- Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo
- Medical Faculty, University of Pristina, Republic of Kosovo
- Veterinary Institute, Pristina, Republic of Kosovo
| | - Paolo Porcu
- Department of Vascular Surgery, University Clinical Center of Grenoble, Grenoble, 38000, France
| | - Philippe Cinquin
- Department of Vascular Surgery, University Clinical Center of Grenoble, Grenoble, 38000, France
- University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, France
| | - Carmine Sessa
- Department of Vascular Surgery, University Clinical Center of Grenoble, Grenoble, 38000, France
- University of Grenoble Alpes, Grenoble 38000, France
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Shah A, Ossei-Gerning N. Intractable ventricular fibrillation: post ascending aortic dissection repair. Cardiovasc Revasc Med 2014; 15:362-4. [PMID: 24908618 DOI: 10.1016/j.carrev.2014.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/01/2014] [Indexed: 11/18/2022]
Abstract
Ascending aortic dissection is a life threatening surgical emergency and carries high peri-operative mortality. Various biological adhesive materials are commonly used in such a surgery to enhance strengthening of separated layers of aortic wall. Despite of extensive use, embolization of the glue material remains a feared complication. Here we are describing a case where BioGlue embolized down the left main stem and resulted in refractory ventricular arrhythmia and hemodynamic instability.
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Affiliation(s)
- Ashish Shah
- University hospital of Wales, Cardiff, CF14 4XW, UK.
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Abstract
PURPOSE To prospectively evaluate the efficacy of albumin glutaraldehyde tissue adhesive (BioGlue) in the surgical treatment of patients with hypospadias. MATERIALS AND METHODS Two groups of 20 patients each who underwent hypospadias repair were included in the study. In the first group we utilized BioGlue as an additional protective layer to the suture line of the neo-urethra, while patients in the second group were operated on utilizing a routine surgical technique. RESULTS There were no statistical differences between patients from the 2 groups in terms of surgical complications. Urethrocutaneous fistula was revealed in 4 (20%) patients after repair with BioGlue and in 3 (15%) patients from the control group (p = 0.686), suture line breakdown in 4 (20%) and in 1 (5%) patients (p = 0.478), meatal stenosis in 1 (5%) and in 1 (5%) patient (p = 1). Furthermore more patients in the BioGlue group (n = 12, 60%) demonstrated poor cosmetic results compared to the control group where most patients - 19 (95%) had acceptable cosmetic outcomes (p = 0.007). CONCLUSIONS Our data showed no benefits of BioGlue use in hypospadias repair.
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Affiliation(s)
- Stanislav Kocherov
- Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Genady Lev
- Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
| | - Boris Chertin
- Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, Jerusalem, Israel
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