The impact of gelatin-resorcinol glue on aortic tissue: A histomorphologic evaluation

Abstract

Gelatin-dialdehyde glue is able to produce the same effects in the area of the aortic wall as the substantially more toxic gelatin-resorcinol-formaldehyde glue and thus could be recommended for clinical trials for treating acute aortic dissections thus far yielding excellent initial results.

Tissue reaction to three different types of tissue glues in an experimental aorta dissection model: a quantitative approach

“…Bachet et al 2000;Chao and Torchiana 2003;Ennker et al 1994;Fürst and Banerjee (e.g. Fehrenbacher and Siderys 2006;Hewitt et al 2001;Mitrev et al 2007), contains bovine serum albumin and glutaraldehyde as a protein cross-linking reagent instead of the more toxic formaldehyde (Chao and Torchiana 2003).…”

Tissue adhesives in ocular surgery

“…Concerns about formaldehyde's mutagenicity and carcinogenicity led Ennker and coinvestigators to replace the formaldehyde component of the glue and combine gelatin instead with less toxic aldehydes such as glutaraldehyde and glyoxal (gelatine-dialdehyde), pentanedial and ethanedial (GR-DIAL), and other CXL agents [158]. The gelatine-dialdehyde was tested on aortic tissue of pigs [159] and the GR-DIAL was tested on lung incisions in rabbits [160], as well as on lung parenchyma defects of rats [161]. These modified gelatin-based adhesives were reported to be resorbed in vivo without interfering with the healing process, and was shown to have no carcinogenic, mutagenic or toxic effects.…”

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

“…No necrotic findings, but nonspecific dense acellular fibrous tissue with islands of hyaline material and widespread hemosiderin deposition, 7 and degeneration in the medial layer without necrosis, 10 which indicated severe local inflamation with bleeding, and a healing process at the site of GRF use, have each been reported. 11 The important and consistent finding was that reunion in the aortic wall by GRF glue was incompletely or never accomplished in a number of patients.…”

“…Since formalin itself is considered to be carcinogenic and mutagenic, the use of a different aldehyde, dialdehyde, to polymerize Gelatin-Resorcin mixture has been tested. 11 Also, the use of glutalaldehyde to enforce the aortic wall in the treatment of aortic dissection has been favorably reported. 23 These new materials and/or techniques are expected to be ready soon for clinical use, although it would still require a long time for these to be tested for their safety and effectiveness, especially concerning late complications.…”

“…Since this complication has been considered to be mostly caused by use of excess formalin, 11,12 we have recently taken great care when the formalin was applied. It is suggested that just 2-3 droplets of formalin, or less, is enough to polymerize 1ml of GelatinResorcin mixture.…”