title: The efficacy and mid-term results with use of gelatin resorcin formalin (GRF) glue for aortic surgery.
abstract: Twenty-six patients were treated by surgical procedure for aortic diseases with use of Gelatin Resorcin Formalin (GRF) glue. They consisted of 25 cases of emergency surgery for type A acute aortic dissection (AAD) and one elective case of distal arch aneurysm. Fifteen patients had moderate to massive aortic regurgitation (AR). We applied GRF glue to adhere the false lumen. It was further applied to anastomosed stitches from the outer side of the aorta. We evaluated the intraoperative effects of it in terms of adhesion and hemostasis and postoperative aortic regurgitation. Furthermore, the mid-term survival rate was investigated. In all cases, the 2 layers were able to be adhered successfully. Furthermore, it was very easy for suturing to pass through the aortic wall, even though the aortic stump was very hard. However, in the distal arch aneurysm case, additional sutures were needed to control the bleeding from the anastomosis. In postoperative aortography, residual AR was found in only one case. Operative deaths were indicated in 3 cases (11.5%). One patient died of hepatic failure on the 9th postoperative day. The other patients died of multiple organ failure. There were 3 cases of late death. The actuarial survival rate at 35 months was 76. 9%. According to these results, we recommend that GRF glue is very effective to reinforce the diseased aortic wall and will improve long-term survival. However, it is considered that the hemostasis effect of GRF glue is not sufficient to be used on anastomosed stitches from the outer side of the aorta.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-0081.
authors.forename: M
authors.initials: M
authors.lastname: Hata
authors.forename: M
authors.initials: M
authors.lastname: Shiono
authors.forename: Y
authors.initials: Y
authors.lastname: Orime
authors.forename: S
authors.initials: S
authors.lastname: Yagi
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Okumura
authors.forename: S
authors.initials: S
authors.lastname: Kimura
authors.forename: S
authors.initials: S
authors.lastname: Kashiwazaki
authors.forename: S
authors.initials: S
authors.lastname: Choh
authors.forename: N
authors.initials: N
authors.lastname: Negishi
authors.forename: Y
authors.initials: Y
authors.lastname: Sezai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D004338:Drug Combinations; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005557:Formaldehyde; D005780:Gelatin; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012118:Resorcinols; D016019:Survival Analysis; D015996:Survival Rate; D014014:Tissue Adhesives; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000401:mortality
chemical_list: D004338:Drug Combinations; D012118:Resorcinols; D014014:Tissue Adhesives; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin