BioGlue surgical adhesive for thoracic aortic repair during coagulopathy: efficacy and histopathology.
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 1,497 +/- 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.
Hewitt
C W
CW
Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Cooper Hospital/University Medical Center, Camden, USA. chewitt@umdnj.edu
Marra
S W
SW
Kann
B R
BR
Tran
H S
HS
Puc
M M
MM
Chrzanowski
F A
FA
Tran
J L
JL
Lenz
S D
SD
Cilley
J H
JH
Simonetti
V A
VA
DelRossi
A J
AJ
D000714:Anastomosis, Surgical; D000818:Animals; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D019917:Blood Vessel Prosthesis Implantation; D004338:Drug Combinations; D005976:Glutaral; D006488:Hemostasis, Surgical; D012710:Serum Albumin, Bovine; D012756:Sheep; D013529:Surgical Wound Dehiscence / Q000473:pathology / Q000601:surgery*; D014014:Tissue Adhesives; D014945:Wound Healing / Q000502:physiology
D004338:Drug Combinations; D014014:Tissue Adhesives; D012710:Serum Albumin, Bovine; D005976:Glutaral