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Ann Thorac Surg 2001;71:1609-1612
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

BioGlue surgical adhesive for thoracic aortic repair during coagulopathy: efficacy and histopathology

Charles W. Hewitt, PhDa, Steven W. Marra, MDa, Brian R. Kann, MDa, Hoang S. Tran, MDa, Matthew M. Puc, MDa, Frank A. Chrzanowski, Jr, MDa, Jean-Luc V. Tran, BAa, Steven D. Lenz, DVM, PhDb, Jonathan H. Cilley, Jr, MDa, Vincent A. Simonetti, MDa, Anthony J. DelRossi, MDa

a Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Cooper Hospital/University Medical Center, Camden, New Jersey, USA
b Department of Pathobiology, Auburn University College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA

Address reprint requests to Dr Hewitt, 3 Cooper Plaza, Suite 411, Camden, NJ 08103
e-mail: chewitt{at}umdnj.edu

Presented at the Poster Session of the Thirty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 31–Feb 2, 2000.

Background. We hypothesized that induction of coagulopathy in sheep would model clinical needle hole and surgical bleeding from synthetic graft anastomoses, and that a new tissue bioadhesive (BioGlue) would control postoperative blood loss during surgical repair of the thoracic aorta.

Methods. Sheep were anticoagulated with aspirin and heparin. A bypass was made using end-to-side anastomoses of a graft to a partially occluded descending thoracic aorta. Experimental anastomoses (EXP, n = 9) were treated with BioGlue, and control anastomoses (CON, n = 5) were treated with Surgicel to gain intraoperative hemostasis.

Results. EXP animals exhibited significantly reduced postsurgical bleeding (CON median 955 mL versus EXP median 470 mL, p < 0.003), a reduced rate of blood loss over the first 2 postoperative hours (CON median 210 mL/hr versus EXP median 92.5 mL/hr, p < 0.006), and over the entire recovery period (CON median 158 mL/hr versus EXP median 86 mL/hr, p < 0.05), and reduced total blood loss (CON mean 1497 ± 691 mL versus EXP mean 668 ± 285 mL, p < 0.008). On histologic examination of tissues explanted after 3 months, BioGlue was relatively inert and demonstrated a minimal inflammatory response.

Conclusions. The use of BioGlue significantly reduced the volume and rate of postsurgical bleeding in a coagulopathic sheep model for thoracic aortic operations. Histopathologically, BioGlue generated only a minimal inflammatory response. This new surgical tissue bioadhesive should prove extremely beneficial for coagulopathic patients undergoing thoracic aortic or vascular procedures.




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