Use of fibrin sealant for reinforcing arterial anastomoses. 1984

H Jakob, and C D Campbell, and Z K Qiu, and R Pick, and R L Replogle

Despite improvements in needles, sutures, and technique, hemorrhage remains a problem in cardiovascular surgery. In this study conventional vascular suture lines and suture lines reinforced with fibrin sealant are compared for blood loss and burst strength. Bilateral femoral arteries in 20 dogs were divided at 50% of their circumference and repaired with six 6-0 polypropylene sutures. Ten animals were systemically heparinized (3 mg/kg), and 10 were not on anticoagulants. The right femoral artery anastomosis was treated with fibrin sealant in all animals, and the left suture line served as the control. Three minutes after initiation of the sealing procedure, blood flow was reinstituted in both femoral arteries. After 3 minutes a significant difference in blood loss between the conventional suture technique and fibrin-reinforced anastomoses was noted in both heparinized (12.1 +/- 2.79 vs. 0.13 +/- 0.06 ml/min; p less than 0.01) and nonheparinized dogs (8.45 +/- 1.37 vs. 0.20 +/- 0.08 ml/min; p less than 0.001). After 30 minutes volume inflow and pressure catheters were inserted into snared compartments encompassing the femoral artery anastomosis. Continuous pressure recordings during volume loading with normal saline solution demonstrated increased bursting pressures of the fibrin-sealed suture lines in both the heparinized (317.5 +/- 13.18 vs. 135 +/- 23.17 mm Hg; p less than 0.001) and nonheparinized animals (474.5 +/- 26.82 vs. 311 +/- 29.31 mm Hg; p less than 0.001). Histologic examination revealed no fibrosis or foreign body reaction and complete resorption of the fibrin sealant within 3 weeks. Fibrin sealant, a powerful hemostatic agent produced from human donors not suffering from hepatitis, decreases blood loss and strengthens suture lines.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005263 Femoral Artery The main artery of the thigh, a continuation of the external iliac artery. Common Femoral Artery,Arteries, Common Femoral,Arteries, Femoral,Artery, Common Femoral,Artery, Femoral,Common Femoral Arteries,Femoral Arteries,Femoral Arteries, Common,Femoral Artery, Common
D005339 Fibrin Foam A dry artificial sterile sponge of fibrin prepared by clotting with thrombin a foam or solution of fibrinogen. It is used in conjunction with thrombin as a hemostatic in surgery at sites where bleeding cannot be controlled by more common methods. (From Martindale, The Extra Pharmacopoeia, 30th ed, p648) Fibrospum,Spongostan,Foam, Fibrin
D006470 Hemorrhage Bleeding or escape of blood from a vessel. Bleeding,Hemorrhages
D006487 Hemostasis The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION. Hemostases
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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