An An Open-Label, Single Center, Retrospective Study to Evaluate Clinical Outcomes with Surgical Sealant in Bentall Procedures: A Cohort Study

  • Jiawei Gu Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Hao Lai Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Jun Li Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Yongxin Sun Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Chen Liu Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Yulin Wang Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Zhiqi Zhang Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Le Kang Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Ben Huang Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China
  • Chunsheng Wang Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China

Abstract

Background: Cardiovascular surgery is associated with substantial risk for postoperative bleeding with increased patient morbidity and mortality.
Numerous intraoperative techniques have been utilized to reduce this risk. This study was to assess postoperative bleeding-related parameters following Bentall procedures and to examine the impact of intraoperative surgical
sealant application.

Method: The medical/surgical records of 100 consecutive Bentall procedure cases were examined retrospectively for perioperative surgical sealant use and postoperative bleeding-related outcomes.

Results: Of the 100 patient cases, three died during the postoperative period, and 97 were evaluable. Surgical sealant was utilized in 56 patient cases (57.8%). The utilization versus no utilization of surgical sealant was associated with significant reductions in most postoperative bleeding-related parameters, including less drainage
(P = .028), resternotomy for hemorrhage (P = .036), transfusion of red blood cells (P = .022 at 48 hours; P = .027 total in-hospital), transfusion of fresh frozen plasma (P = .04 at 48 hours; P = .004 total in-hospital), and a higher percentage of cases not needing blood transfusion (P = .002). The surgical sealant group had longer cardiopulmonary bypass circuit (P = .016) and aortic cross-clamp time (P = .001), with no significant between-group differences in intubation time (P = .636) or intensive care unit duration (P = .294). When excluding urgent cases or Stanford type A aortic dissections, intensive care unit duration significantly was shorter in the surgical sealant group (P = .017). Surgical sealant use was not associated with any adverse events.

Conclusion: The application of surgical sealant to the anastomosis suture line in Bentall procedures reduces postoperative drainage, bleeding, and transfusion utilization. Further studies are warranted to investigate these benefits in prospective, randomized
clinical trials.

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Published
2019-09-24
How to Cite
Gu, J., Lai, H., Li, J., Sun, Y., Liu, C., Wang, Y., Zhang, Z., Kang, L., Huang, B., & Wang, C. (2019). An An Open-Label, Single Center, Retrospective Study to Evaluate Clinical Outcomes with Surgical Sealant in Bentall Procedures: A Cohort Study. The Heart Surgery Forum, 22(5), E396-E400. https://doi.org/10.1532/hsf.2433
Section
Articles