| Late Aortic Root Redissection
Following Surgical Repair for Acute Aortic Dissection Using Gelatin-Resorcin-Formalin
Glue: Report of 2 Cases |
(Department of Surgery, Division of Clinical Medical
Science, Graduate School of Biomedical Sciences, Hiroshima University,
Hiroshima, Japan)
| Yuji Sugawara |
Katsuhiko Imai |
Kazuhiro Kochi |
| Kenji Okada |
Kazumasa Orihashi |
Taijiro Sueda |
|
Gelatin-resorcin-formalin (GRF)
glue has been generally applied in the surgical treatment of
acute aortic dissection. Recently, midterm or late redissection
and false anastomotic aneurysm following the use of this adhesive
have been reported in several articles and the toxicity of its
component has been suggested to be involved in this complication.
We herein report 2 cases of aortic root redissection a few years
after the initial surgery for type A acute aortic dissection.
In another hospital, a 57-year-old man had undergone total arch
replacement for acute dissection in which the proximal end was
repaired using GRF glue. The aortic root was revealed to be redissected
by computed tomography (CT) 2 years after the intervention and
continued to enlarge since then. This aortic complication was
treated by composite graft replacement. The intraoperative findings
of marked degeneration in dissected root tissue were impressive.
The other patient was a 71-year-old man. He had undergone prosthetic
replacement of the ascending aorta associated with aortic valve
resuspension using GRF glue for acute dissection. Three years
later, symptoms of cardiac failure due to aortic regurgitation
(AR) occurred and necessitated surgical correction. The AR was
due to the redissection of the non-coronary cusp sinus. Repair
of the coronary sinus and aortic valve replacement was performed.
The postoperative course was uneventful in both cases. Other
papers have cautioned that this tissue adhesive should not be
used in aortic valve resuspension. Intensive long-term follow-up
is required for aortic dissection patients surgically treated
using this glue.
Jpn. J. Cardiovasc. Surg. 33: 22 -25 (2004) |
|
