A novel synthetic sealant to treat air leaks at cardiac reoperation.
OBJECTIVE
Pulmonary injury with resultant air leak is common at cardiac reoperation. Sequelae of this complication include prolonged chest tube drainage and time to ambulation, extended hospitalization and increased costs, and mediastinitis. The purpose of this study was to test the efficacy of a new synthetic absorbable sealant at treatment air leaks occurring at cardiac reoperation.


METHODS
Fifteen patients having cardiac reoperation had lung injuries repaired with FocalSeal-L Sealant (Focal, Inc., Lexington, MA). Mean age was 61+/-15 years, and mean interval from the previous to the current operation was 44+/-38 months.


RESULTS
In all patients, FocalSeal-L Sealant was successful at sealing intraoperative air leaks. Postoperatively, 73% of patients had no air leak. Four patients (27%) developed a recurrent air leak, three on postoperative day 1 and one on postoperative day 2. In three of these patients, the air leak sealed within 3 days. In the fourth patient, an immunosuppressed heart transplant recipient with mediastinitis, the air leak never sealed; that patient died of sepsis after an omental flap failed to control the air leak. In patients without air leak, chest tubes were removed on postoperative day 1 (9 patients) or 2 (1 patient).


CONCLUSIONS
This novel synthetic sealant prevents postoperative air leaks in the majority of patients suffering lung injury at cardiac reoperation.
Gillinov
A M
AM
Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA. gillinom@ccf.org
Lytle
B W
BW
D001672:Biocompatible Materials; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D014014:Tissue Adhesives
D001672:Biocompatible Materials; D014014:Tissue Adhesives