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

• Published in: The Annals of thoracic surgery Vol. 71; no. 5; pp. 1609 - 1612
• Main Authors: Hewitt, Charles W, Marra, Steven W, Kann, Brian R, Tran, Hoang S, Puc, Matthew M, Chrzanowski, Frank A, Tran, Jean-Luc V, Lenz, Steven D, Cilley, Jonathan H, Simonetti, Vincent A, DelRossi, Anthony J
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2001; Elsevier Science
• Subjects: Anastomosis, Surgical; Animals; Aorta, Thoracic - pathology; Aorta, Thoracic - surgery; Biological and medical sciences; Blood Loss, Surgical - physiopathology; Blood Vessel Prosthesis Implantation; Drug Combinations; Glutaral; Hemostasis, Surgical; Medical sciences; Serum Albumin, Bovine; Sheep; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgical Wound Dehiscence - pathology; Surgical Wound Dehiscence - surgery; Tissue Adhesives; Wound Healing - physiology; Surgical anastomosis; Surgical glue; Exploration; Hemopathy; Descending aorta; Thoracic aorta; Pathology; Vertebrata; Concomitant disease; Experimental disease; Mammalia; Surgery; Animal; Blood loss; Graft; Sheep; Biomaterial; Artiodactyla; Ungulata; Coagulopathy
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(01)02424-9

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.