A Case of Stanford Type A Dissecting Aneurysm with Reinforcement of Suture Line by Glutaraldehyde Solution. Effect and Side Effect.
10.4326/jjcvs.21.200
- VernacularTitle:吻合部にグルタルアルデヒド処理を行ったＡ型解離性大動脈りゅうの１治験例 補強効果と合併症について
- Author:
Atsushi AMANO
;
Masaaki TOYAMA
;
Kazuo YANAGI
;
Hiroaki TANABE
;
Takeshi SATOH
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1992;21(2):200-203
- CountryJapan
- Language:Japanese
-
Abstract:
A 71-year-old woman was admitted with severe back pain. She was diagnosed of type A dissecting aortic aneurysm and two-vessel coronary disease by CT scan and angiography. An acute-phase operation was started 32 hours after onset, performing replacement of ascending aorta and a two-vessel bypass. The affected aortic wall was so thin and fragile that the cut ends of these wall were treated with 25% solution of glutaraldehyde, a fastacting crosslinking agent, for 7min. As a result, a sufficient degree of reinforcement was obtained to complete the anastomotic procedure safely. She made a good recovery of cardiac function after the surgery, but was left with such complications as permanent complete atrioventricular block and a little aortic regurgitation. Following pacemaker insertion she was discharged and has returned to her normal activity. It appears that when treating the affected aortic wall with glutaraldehyde, a piece of gauze placed in the left ventricular cavity stopped up the aortic valve by half. As a result, glutaraldehyde was perhaps transferred from the gauze to the aortic valve and a part of the conduction system, causing injury to them. If meticulous care is exercised during the procedure to avoid unnecessary invasion of surrounding tissues, this technique will provide a useful means to accomplish safe anastomoses of cardiac vessels.
