Background: Fibrin glue effectively controls air leakage in lung surgery; however, allogenic fibrin glue cannot eliminate the risks of infection and allergy despite current sterilization methods. Autologous fibrin glue (AFG) could be a good alternative, but is not commonly used worldwide because of its limited availability and lack of evidence. Herein, we report clinical outcomes of AFG in thoracic surgery. Methods: We retrospectively analyzed patients who underwent lobectomies or segmentectomies betweenNovember 2016 and September 2017 in our institution. We used two types of AFGs. One was a partiallyautologous fibrin glue (PAFG), the components of which are largely autologous but which contains allogenic thrombin. The other was a completely-autologous fibrin glue (CAFG) which has no allogenic components.PAFG was used in the first half of the study period, after which CAFG was used from March 2017 onward.Patients who did not undergo AFG generation were categorized as the non-AFG group. The perioperative outcomes of the three groups were evaluated.Results: A total of 207 patients underwent lung surgery, including 118 lobectomies and 89 segmentectomies. Among them, 83 patients received PAFG, 94 received CAFG, and 30 received non-AFG.The mean postoperative drainage period was within a few days in each group (PAFG vs. CAFG vs. non-AFG: 3.23±3.91 vs. 3.16±4.04 vs. 3.17±4.16 days, respectively; P=0.405), and the incidence of postoperative prolonged air leakage was within an acceptable range (PAFG vs. CAFG vs. non-AFG: 13.3% vs. 12.8% vs.16.7%, respectively; P=0.821). Conclusions:The use of AFG is clinically feasible for patients who undergo lobectomies or segmentectomies. AFGs could be a viable alternative to conventional allogenic fibrin glues.

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Intramyocardial dissection (ID) is a rare left ventricular (LV) disorder characterized by myocardial fibre dissection and neocavitation. In this study, we present a rare case of a 66-year-old woman who had a history of sarcoidosis with non-ischaemic ID following total arch replacement. ID developed suddenly in the free wall of the LV and expanded rapidly to form an LV aneurysm. We successfully performed LV reconstructive surgery to prevent ID rupture.

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