Is biologic glue the inexperienced surgeon's best friend?

Yang, Bo

doi:10.1016/j.jtcvs.2018.11.073

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…The indication for aortic root replacement in patients with ATAAD included (1) intimal tear at the aortic root, (2) root diameter of 4.5 cm or greater, (3) connective tissue disease, and (4) unrepairable aortic valve pathology. 10,11 The root procedures include direct repair 11,12 or replacement as inclusion root, Bentall procedure, or David procedure. 10,11,13 Indications for zone 1 to 3 arch replacement included an arch aneurysm greater than 4 cm or intimal tear located in the arch, which could not be resected by a hemiarch replacement, or dissection of arch branch vessels with malperfusion syndrome.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Is previous cardiac surgery a risk factor for open repair of acute type A aortic dissection?

Norton

Rosati

Kim

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Section: Surgical Techniquesmentioning

confidence: 99%

Is previous cardiac surgery a risk factor for open repair of acute type A aortic dissection?

Norton

Rosati

Kim

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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“…These outcomes support the direct repair of dissected aortic root, arch, or aortic branch vessels without any surgical adjuncts or inversion of adventitia and is safe and effective. 3,4 FIGURE 1. A 65-year-old female patient presented with acute type A aortic dissection complicated with innominate artery and right carotid artery dissection/occlusion and right cerebral stroke.…”

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confidence: 99%

Reply From the authors: Can we just trust our suture lines!

Yang

2020

The Journal of Thoracic and Cardiovascular Surgery

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In this issue of the Journal, Motekallemi and colleagues 1 commented on the techniques of aortic root repair in acute type A aortic dissection (ATAAD) and reported their technique of modified adventitial inversion in contrast to the buttress suture reported by Takana and colleagues. 2 It is a simple technique, as shown in their figure, where they obliterate the false lumen in the aortic root without using Teflon felt or biological glue, which is potentially toxic to the aortic tissue and a challenge for reoperations. 3,4 Surgeons have been very cautious when handling the dissected aorta in ATAAD. The worry of sutures tearing the dissected aorta and dissection flap at the anastomoses supported surgeons using Teflon felt, biological glue, or adventitial inversion as tissue reinforcement. Using adventitia may offer a solution without using Teflon felt or biological glue, both of which, although efficacious, could cause pseudoaneurysms at the anastomotic sites and offer future potential challenges for reoperations. 3,4 The adventitia inversion technique has been used by my colleagues at the University of Michigan as well. However, I personally do not use the inversion of adventitia for the following reasons: (1) aortic adventitia is composed of connective tissue, including fibroblasts, pericytes, and adipocytes in the supporting environment of Author has nothing to disclose with regard to commercial support.

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Is biologic glue the inexperienced surgeon's best friend?

Cited by 2 publications

References 8 publications

Is previous cardiac surgery a risk factor for open repair of acute type A aortic dissection?

Is previous cardiac surgery a risk factor for open repair of acute type A aortic dissection?

Reply From the authors: Can we just trust our suture lines!

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