ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stephen W. Downing
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Downing, S. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Downing, S. W.
Related Collections
Right arrow Great vessels

Ann Thorac Surg 2003;75:1063
© 2003 The Society of Thoracic Surgeons

Correspondence

What are the risks of using biologic glues?

Stephen W. Downing, MD

Division of Cardiac Surgery, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD 21201, USA

e-mail: sdowning{at}smail.umaryland.edu

To the Editor:

The article by Kazui and colleagues [1] on the role of biologic glue and the risk to aortic root redissection caught my attention. In the last 1 years, I have reoperated (for pseudoaneurysm) on 3 of approximately the last 15 patients where Bio-glue was used to assist in the repair of a dissection of the ascending or aortic arch. I cannot recall a pseudoaneurysm in my non-glue patients. This may be purely chance, but it does raise my suspicion that the glue may be having unexpected consequences. In the literature, several authors have suggested that the use of aortic glue is associated with local tissue damage, a local inflammatory response, or an increased risk of pseudo-aneurysm formation [1–4].

Pseudoaneurysms in patients treated with a glue may arise for many reasons including:

  1. Local cell death from toxic products in the glue that lead to tissue breakdown over time.
  2. The aortic glue may have stopped bleeding in an area that would have been better served over the long term with a suture than by glue closure (analogous to duct taping an area that should have been bolted together).
  3. Patients who would not have survived surgery due to bleeding from coagulopathy and local tissue compromise are now surviving. They may be at more risk for late complications than patients who did not need the glue to get out of the operating room.

If there is a trend toward more pseudoaneurysms in glue-treated patients, hopefully, it will be due to reason number three and not numbers one and two. Biologic glues may be very useful, but there is not free lunch in this world. We should be alert for any patterns of late complications that would suggest that the use of biologic glue has some downsides.

References

  1. Kazui T., Washiyama N., Bashar A.H., et al. Role of biologic glue repair of proximal aortic dissection in the development of early and midterm redissection of the aortic root. Ann Thorac Surg 2001;72:509-514.[Abstract/Free Full Text]
  2. Bingley J.A., Gardner M.A., Stafford E.G., et al. Late complications of tissue glues in aortic surgery. Ann Thorac Surg 2000;69:1764-1768.[Abstract/Free Full Text]
  3. Martinelli L., Graffigna A., Guarnerio M., Bonmassari R., Disertori M. Coronary artery narrowing after aortic root reconstruction with resorcin-formalin glue. Ann Thorac Surg 2000;70:1701-1702.[Abstract/Free Full Text]
  4. Katsumata T., Moorjani N., Vaccari G., Westaby S. Mediastinal false aneurysm after thoracic aortic surgery. Ann Thorac Surg 2000;70:547-552.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
S. A. LeMaire
Invited commentary
Ann. Thorac. Surg., May 1, 2007; 83(5): 1626 - 1627.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Szafranek, S.R. Podila, W. Al-Khyatt, and E.N. Kulatilake
Aseptic mediastinal cyst caused by BioGlue 7 months after cardiac surgery
J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1202 - 1203.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. Furst and A. Banerjee
Release of Glutaraldehyde From an Albumin-Glutaraldehyde Tissue Adhesive Causes Significant In Vitro and In Vivo Toxicity
Ann. Thorac. Surg., May 1, 2005; 79(5): 1522 - 1528.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. L. Ngaage, W. D. Edwards, M. R. Bell, and T. M. Sundt
A cautionary note regarding long-term sequelae of biologic glue
J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 937 - 938.
[Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stephen W. Downing
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Downing, S. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Downing, S. W.
Related Collections
Right arrow Great vessels

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS