title: BioGlue surgical adhesive impairs aortic growth and causes anastomotic strictures.
abstract: BACKGROUND
  BioGlue surgical adhesive (CryoLife, Inc, Kennesaw, GA) is currently being used to secure hemostasis at cardiovascular anastomoses in adults. Interference with vessel growth would preclude its use during congenital heart surgery. The purpose of this study was to determine if BioGlue reinforcement of aortic anastomoses impairs vessel growth and causes strictures.
  
  
  METHODS
  Ten 4-week-old piglets (8.0 +/- 1.4 kg) underwent primary aorto-aortic anastomoses. Five piglets were randomly assigned to anastomotic reinforcement with BioGlue. After a 7-week growth period, the aortas were excised for morphometric analysis and histopathology.
  
  
  RESULTS
  Weight gains were similar in both groups. In BioGlue animals, however, aortic circumference increased only 1.5 +/- 0.8 mm (versus 2.7 +/- 0.8 mm in controls; p = 0.054). BioGlue animals developed a 33.9% stenosis of the aortic lumen area (versus 3.7% in controls, p = 0.038). Adventitial changes reflecting tissue injury and fibrosis were present in all BioGlue animals versus none of the control animals (p = 0.008).
  
  
  CONCLUSIONS
  BioGlue reinforcement impairs vascular growth and causes stricture when applied circumferentially around an aorto-aortic anastomosis. This adhesive should not be used on cardiovascular anastomoses in pediatric patients.
authors.affiliation: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. slemaire@bcm.tmc.edu
authors.forename: Scott A
authors.initials: SA
authors.lastname: LeMaire
authors.forename: Zachary C
authors.initials: ZC
authors.lastname: Schmittling
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Coselli
authors.forename: Akif
authors.initials: A
authors.lastname: Undar
authors.forename: Blake A
authors.initials: BA
authors.lastname: Deady
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Clubb
authors.forename: Charles D
authors.initials: CD
authors.lastname: Fraser
mesh_terms: D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery*; D002455:Cell Division / Q000187:drug effects*; D003251:Constriction, Pathologic; D005976:Glutaral / Q000633:toxicity*; D006488:Hemostasis, Surgical; D012710:Serum Albumin, Bovine / Q000633:toxicity*; D013552:Swine; D014014:Tissue Adhesives / Q000633:toxicity*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D014014:Tissue Adhesives; D012710:Serum Albumin, Bovine; D005976:Glutaral