title: Devised reinforcement of distal stump in total arch replacement using BioGlue.
abstract: Although thoracic endovascular aortic repair and the open stent-grafting technique have become popular, surgical replacement of the aorta remains the procedure of choice for arch aneurysms. Distal anastomosis in total arch replacement is fraught with danger in the patient with a fragile aortic wall, and can lead to uncontrollable bleeding from the fragile distal stump with existing reinforcement techniques. We describe an easy and secure distal anastomosis reinforcement technique, the "BioGlue rolled sandwich technique", for total arch replacement, which avoids the difficulties of application of BioGlue near the vagus and phrenic nerves.
authors.affiliation: Department of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan tokunaga@kanagawa-junko.jp.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Tokunaga
authors.affiliation: Department of Cardiovascular Surgery, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011506:Proteins / Q000627:therapeutic use*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives
keywords: Anastomosis; Aorta; Aortic diseases; Blood vessel prosthesis implantation; Thoracic surgical procedures; Tissue adhesives; surgical; thoracic