Improving outcomes through the use of surgical sealants for anastomotic sealing during cardiovascular surgery.
The continued need to minimize blood product usage both during and after cardiac surgical procedures has been challenged by a changing patient population, and most recently by the withdrawal of the antifibrinolytic aprotinin (Trasylol, Bayer Pharmaceuticals, West Haven, CT, USA) from the market. To meet these challenges, a variety of topical hemostatic tools have continued to emerge in the surgical armamentarium. These include hemostatic agents, adhesives, and sealants designed to control perioperative bleeding and decrease blood product utilization. Optimal application of novel topical adjuncts can be limited due to the lack of clarity on how to differentiate between these adjunctive hemostatic products and their appropriate uses. This paper will review the classes of these products, how and where such products can be used during cardiovascular surgery for achieving hemostasis, and the potential for improved outcomes through the appropriate selection and use of these agents.
DeAnda
Abe
A
Montefiore Medical Center/Albert Einstein College of Medicine, Department of Cardiothoracic Surgery, Bronx, New York 10467, USA. adeanda@montefiore.org
Elefteriades
John A
JA
Hasaniya
Nahidh W
NW
Lattouf
Omar M
OM
Lazzara
Robert R
RR
D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D006489:Hemostatic Techniques; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D014014:Tissue Adhesives