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Maximization of the sealing effect of fibrin glue in aortic surgery

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Abstract

Objectives

Fibrin glue is used to reinforce anastomosis in aortic surgery. There has not yet been a consensus on how it should be applied optimally. This study aimed to define the optimal condition of applying fibrin glue.

Methods

In experiment 1, we determined the optimal condition for spraying fibrin glue using an expanded polytetrafluoroethylene graft within a needle hole. The length and area of the fibrin cap within the hole were measured. In experiment 2, methods for applying fibrinogen were assessed by comparing brushing and spraying. In experiment 3, swine aorta segments sutured with a Dacron graft were divided into the following three groups: nothing was applied; fibrinogen was sprayed and rubbed using brush. The aorta was clamped and blood was infused from an occlusion catheter inserted into the graft. The pressure at the first appearance of blood leak was recorded.

Results

In experiment 1, among the four groups divided by the pressure and distance of spraying, the fibrin cap area in the group with 0.075 MPa and 2-cm spray distance was significantly larger than that in the group with 0.15 MPa and 2 cm (P < 0.01). In experiment 2, the fibrin cap area in the brushing group was significantly larger than that in the spraying group (P < 0.05). In experiment 3, the capacity to resist endoluminal pressure was higher in the brushing and combined spraying group compared with that in the sequential combined spraying group (P < 0.01).

Conclusions

The brush and spray methods showed excellent hemostatic outcomes.

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Acknowledgements

We would like to thank Editage (http://www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan

    Masaaki Naganuma, Masatoshi Akiyama, Hiroki Takaya, Kei Sakuma, Kiichiro Kumagai, Shunsuke Kawamoto, Osamu Adachi & Yoshikatsu Saiki

Authors
  1. Masaaki Naganuma
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  2. Masatoshi Akiyama
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  3. Hiroki Takaya
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  4. Kei Sakuma
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  5. Kiichiro Kumagai
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  6. Shunsuke Kawamoto
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  7. Osamu Adachi
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  8. Yoshikatsu Saiki
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Correspondence to Yoshikatsu Saiki.

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Naganuma, M., Akiyama, M., Takaya, H. et al. Maximization of the sealing effect of fibrin glue in aortic surgery. Gen Thorac Cardiovasc Surg 68, 18–23 (2020). https://doi.org/10.1007/s11748-019-01155-x

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  • DOI: https://doi.org/10.1007/s11748-019-01155-x

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