HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael A. Erb Thomas Claus Martin Hartrumpf Johannes M. Albes Permission Requests Google Scholar Articles by Erb, M. A. Articles by Albes, J. M. PubMed Articles by Erb, M. A. Articles by Albes, J. M. Related Collections Coronary disease Minimally invasive surgery Myocardial infarction

The use of Tachosil^® surgical patch or fibrin glue in coronary artery surgery does not affect quality of anastomosis or provoke postoperative adhesions in pigs

^a Department of Cardiovascular Surgery, Heart Centre Brandenburg, Bernau-Berlin, Germany
^b Institute of Vegetative Anatomy, Charité-University Medicine, Berlin, Germany

Received 14 September 2008; received in revised form 23 March 2009; accepted 3 April 2009.

^_* Corresponding author. Address: Department of Cardiovascular Surgery, Heart Centre Brandenburg, Ladeburger Strasse 17, 16321 Bernau bei Berlin, Germany. Tel.: +49 3338 694510; fax: +49 3338 694544. (Email: m.erb{at}immanuel.de).

Objective: Fibrin glue products and collagen surgical patches (TachoSil^®) coated with coagulation factors I and IIa are increasingly being used to prevent oozing from distal or proximal coronary anastomosis. Furthermore, an increasing number of patients are being operated upon anti-platelet therapy. These patients often exhibit diffuse bleeding. Especially in an off-pump scenario surgeons refrain from placing additional stitches in order to avoid an impairment of the graft. In these situations, a biological glue can help resolve this dilemma. It is, however, assumed that these products may exert negative effects on the anastomosis. For obvious reasons a systematic histological assessment in humans is impossible. Therefore, a chronic, large animal model was developed to study the fate of these products on a coronary anastomosis. Methods: In 15 pigs receiving off-pump coronary artery bypass graft of the left mammary artery to the left anterior descending coronary artery, three groups were defined. Group A served as control. In group B the anastomosis was covered with 1 ml fibrin glue; in group C TachoSil^® coverage was performed. Bypass flow (BF) was measured using a Doppler probe. After 3 months the pigs were sacrificed and the anastomoses were evaluated macroscopically and by means of light microscopy regarding patency and fibrosis. Results: In group A, all five animals survived, three of the five anastomoses were patent and the mean BF was 26 ml min^–1. In group B, three of the five animals survived, all anastomoses were patent. The BF was 21 ml min^–1. In group C, all five animals survived, four of the five anastomoses were patent and BF was 21 ml min^–1. Macroscopic and histological evaluation showed no differences between the groups. Remnants of Tachosil^® or fibrin glue were not observed. Conclusions: In the chronic course, no evidence of adverse effects of TachoSil^® or fibrin glue was noted. Both agents can therefore be used safely in clinical practice for haemostyptic or positioning purposes.

Key Words: Fibrin glue • Animal model • CABG • Off-pump • Tachosil^®