Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue

Suehiro, Kotaro; Hata, Takato; Yoshitaka, Hidenori; Tsushima, Yoshimasa; Matsumoto, Mitsuaki; Hamanaka, Sohei; Mohri, Makoto; Ohtani, Satoru; Nagao, Atsuki; Kojima, Toru

doi:10.1007/bf03032285

Cited by 19 publications

(8 citation statements)

References 18 publications

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“…Several other series of CRR report unacceptably high rates of root reoperation with GRF glue alone. In these reports, GRF glue has been associated with tissue necrosis, aortic root redissection, and pseudoaneurysm formation (11)(12)(13)(14). Histologic investigations at the time of reintervention have specifically identified the toxic effects of GRF upon aortic smooth muscle cells and elastin (15,16).…”

Section: Aortic Root Repairmentioning

confidence: 99%

When and how to replace the aortic root in type A aortic dissection

Leshnower

Chen

2016

Ann. Cardiothorac. Surg.

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Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient's anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD. No time or language restrictions were imposed and references of the selected studies were checked for additional relevant citations. Multiple retrospective reviews have demonstrated equivalent operative mortality between aortic root repair and replacement during TAAD. There is a higher incidence of aortic root reintervention with aortic root repair compared to aortic root replacement (ARR). Experienced, high-volume aortic centers have demonstrated the safety of VSRR in young, hemodynamically stable patients presenting with TAAD. In conclusion, aortic root repair can safely be performed in the vast majority of patients with TAAD. Despite the increased surgical complexity, ARR does not increase operative mortality and improves the freedom from root reintervention. VSRR can be performed in highly selected populations of patients with TAAD with durable mid-term valve function.

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Section: Aortic Root Repairmentioning

confidence: 99%

When and how to replace the aortic root in type A aortic dissection

Leshnower

Chen

2016

Ann. Cardiothorac. Surg.

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“…The rate of reoperation for redissection was higher in this series than in others, [5][6][7][8]15,16 which suggests that the development of redissection was more closely related to the technique of anastomosis with GRF glue. The possible factors associated with the technique of anastomosis include the method of compressing the layers of the dissected aortic wall, the duration of compression for polymerization, the temperature of the tissue where glue is applied, and the performance of Teflon-felt reinforcement.…”

Section: Discussionmentioning

confidence: 50%

“…Conversely, there are few reports of redissection after reinforcement on both the inside and outside of the aorta. 8 Therefore, reinforcement on both sides may reduce the possibility of redissection. Aortic root replacement using a composite graft for redissection is well described.…”

Section: Discussionmentioning

confidence: 99%

Influence of Gelatin-Resorcin-Formalin Glue on Mid-Term Redissection After Aortic Repair

et al. 2005

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“…6,9 In fact, we have sometimes used about 2-3 ml of formaldehyde with 15 ml of GR component when reconstructing the dissected tissue, although only 1-2 droplets of formaldehyde to 1 ml of GR component are considered to be adequate. 1,10 In our two cases, the tissue around the redissection seemed to be necrotic intraoperatively, the histological findings of the necrotic area revealed degenerated tissue with degenerated cells.…”

Section: Discussionmentioning

confidence: 99%

Late Complications Following Surgery for Type A Acute Aortic Dissection Using Gelatin-Resorcin-Formaldehyde Glue: Report of Two Cases

et al. 2005

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Gelatin-resorcin-formaldehyde (GRF) glue has been widely applied during operations for acute aortic dissection (AAD). At our institution, GRF glue was applied in 40 patients who underwent surgical procedures for AAD from 1995, two of whom needed a reoperation because of the development of a redissection and/or a pseudoaneurysm at the anastomotic sites. The operative findings and histological examinations suggested that the application of GRF glue during the initial operations might be related to the development of a redissection and/or a pseudoaneurysm.

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Late aortic root redissection following surgical treatment for acute type A aortic dissection using Gelatin-Resorcin-Formalin glue

Abstract: A high incidence of aortic root redissection with false aneurysm and/or aortic insufficiency was found following the surgery for acute aortic dissection using GRF glue. These patients should be carefully followed for years after surgery.

Cited by 19 publications

References 18 publications

When and how to replace the aortic root in type A aortic dissection

When and how to replace the aortic root in type A aortic dissection

Influence of Gelatin-Resorcin-Formalin Glue on Mid-Term Redissection After Aortic Repair

Late Complications Following Surgery for Type A Acute Aortic Dissection Using Gelatin-Resorcin-Formaldehyde Glue: Report of Two Cases

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