[Proximal anastomotic pseudoaneurysm due to gelatin-resorcin-formalin (GRF) glue after replacement of ascending aorta for acute aortic dissection; report of a case].
A 78-year-old man had previously undergone replacement of ascending aorta using gelatin-resorcin-formalin (GRF) glue for acute aortic dissection. Five years later, a follow-up computed tomography (CT) showed an aortic root pseudoaneurysm. Ultrasound cardiography revealed moderate aortic regurgitation and pseudoaneurysm of aortic root. Aortic root replacement was planned based on a clinical diagnosis of an anastomotic pseudoaneurysm of the aortic root. The patient was discharged without complication 26 days after surgery. In the histopathological examination, the necrotic change of smooth muscle cells in the aortic media was revealed. Previous reports suggests that the use of GRF glue for reconstructing the dissected aorta results in higher rates of postoperative redissection or pseudoaneurysm. Therefore, careful postoperative follow-up is necessary in such cases and further improvements in the quality of glue or alternative methods will be necessary to prevent problems in the first place.
Hachimaru
Tsuyoshi
T
Department of Cardiovascular Surgery, Hiroo Hospital, Tokyo, Japan.
Kawaguchi
S
S
Watanabe
M
M
Nakahara
H
H
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000209:etiology*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004338:Drug Combinations; D005500:Follow-Up Studies; D005557:Formaldehyde / Q000009:adverse effects*; D005780:Gelatin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D012118:Resorcinols / Q000009:adverse effects*
D004338:Drug Combinations; D012118:Resorcinols; C027813:gelatin-resorcinol-formaldehyde tissue adhesive; D005557:Formaldehyde; D005780:Gelatin