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Ann Thorac Surg 2000;69:1376-1382
© 2000 The Society of Thoracic Surgeons

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Original articles: Cardiovascular

Controlled clinical trial of a novel hemostatic agent in cardiac surgery

^a Columbia University, College of Physicians and Surgeons, New York, New York, USA
^b The Cleveland Clinic Foundation, Cleveland, Ohio, USA
^c Washington Hospital, Fremont, California, USA
^d California Pacific Medical Center, San Francisco, California, USA

Address reprint requests to Dr Oz, Columbia University, College of Physicians and Surgeons, Milstein Pavilion 7-435, 177 Fort Washington Ave, New York, NY 10032
e-mail: mco2{at}columbia.edu

Background:. We performed a prospective randomized trial to compare FloSeal Matrix (Fusion Medical Technologies, Inc, Mountain View, CA), a gelatin-based hemostatic sealant, with Gelfoam-Thrombin (Gelfoam, Pharmacia and Upjohn, Kalamazoo, MI; Thrombin, Gentrac Inc, Middeton, WI) (control group) to control perioperative bleeding.

Methods:. A total of 93 patients undergoing cardiac operations were randomized into the FloSeal or control group after standard surgical means to control bleeding had failed. The bleeding site was evaluated at 1, 2, 3, 6, and 10 minutes after applying the hemostatic agent. If bleeding stopped within 10 minutes, the application was considered to be successful. In the case of a failure, the surgeon could use any means preferred (except FloSeal) to achieve hemostasis. All bleeding sites in a patient were treated with the hemostatic agent to which the patient was randomized. Follow-up evaluation was performed at 12 to 36 hours and 6 to 8 weeks after operation.

Results:. FloSeal stopped bleeding in 94% of the patients (first bleeding site only) within 10 minutes, compared to 60% in the control group (p = 0.001). At 3 minutes, successful hemostasis was achieved in 72% of the FloSeal group compared with 23% in the control group (p = 0.0001). There was no difference in the adverse event profile between the two groups.

Conclusions:. FloSeal Matrix demonstrated efficacy superior to that of Gelfoam-Thrombin and had a safety profile similar to that of Gelfoam-Thrombin when used as a topical hemostatic agent during cardiac surgery procedures.

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