Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue.
OBJECTIVE
Although Gelatin-Resorcin-Formalin (GRF) glue is widely used in surgery for acute aortic dissection, late complications possibly due to the glue, such as late aortic root redissection, have also been reported. We have experienced similar complications, some of which required redo surgeries, and these cases are reviewed.


METHODS
Twenty-six consecutive patients who underwent surgery for acute type A aortic dissection using GRF glue, from December 1996 to February 2001, were retrospectively studied, with a special focus on any late complications and any reoperation.


RESULTS
Of the 21 patients who survived and were followed as outpatients, false aneurysms were found in 5 patients (21%) at 24-42 (mean 34) months following the initial surgery. Of these, 2 patients required resternotomy because of the increasing aneurysm diameter. In both cases, the aortic root was redissected at the site of the GRF glue use where the anastomosis between the aortic root and the prosthesis had widely opened and had become the aneurysm entry point. Significant aortic regurgitation was noticed in 3 patients (14%, 1 of whom showed a false aneurysm), and 2 of these underwent reoperation for aortic root redissection.


CONCLUSIONS
A high incidence of aortic root redissection with false aneurysm and/or aortic insufficiency was found following the surgery for acute aortic dissection using GRF glue. These patients should be carefully followed for years after surgery.
Suehiro
Kotaro
K
Department of Cardiovascular Surgery, Sakakibara Hospital Cardiovasculary Center, 2-1-10 Marunouchi, Okayama 700-0823, Japan.
Hata
Takato
T
Yoshitaka
Hidenori
H
Tsushima
Yoshimasa
Y
Matsumoto
Mitsuaki
M
Hamanaka
Souhei
S
Mohri
Makoto
M
Ohtani
Satoru
S
Nagao
Atsuki
A
Kojima
Toru
T
D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation; D004338:Drug Combinations; D005557:Formaldehyde / Q000009:adverse effects / Q000627:therapeutic use*; D005780:Gelatin / Q000009:adverse effects / Q000627:therapeutic use*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012118:Resorcinols / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*
D004338:Drug Combinations; D012118:Resorcinols; D014014:Tissue Adhesives; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin