Intravascular air after fibrin sealing by spray gun in cardiovascular surgery.
During an operation for an ascending aortic aneurysm with implantation of a saphenous vein graft to the left coronary artery into a prosthesis, we occasionally observed air bubbles in the graft after application of fibrin glue to the anastomosis to control bleeding. In an experimental study in a pig, a vascular prosthesis was anastomosed to the descending aorta. The aorta and the prosthesis were transected and reanastomosed. Air bubbles were collected in a glass flask placed at the end of the prosthesis. Fibrin glue was applied with a spray catheter on all anastomoses at varying distances and with different air pressures. Small amounts of air were collected in the glass flask when an air pressure of 3 or 4 bar was used. This study demonstrates that the use of fibrin glue in cardiovascular surgery can introduce air into the vascular system with subsequent air emboli as a possible side-effect.
Olsen
P S
PS
Department of Cardiothoracic Surgery RT, Rigshospitalet, Copenhagen, Denmark.
Hjelms
E
E
D000368:Aged; D001014:Aortic Aneurysm / Q000601:surgery*; D004618:Embolism, Air / Q000209:etiology*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006488:Hemostasis, Surgical; D006801:Humans
D015718:Fibrin Tissue Adhesive