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An An Open-Label, Single Center, Retrospective Study to Evaluate Clinical Outcomes with Surgical Sealant in Bentall
1Zhongshan hospital affiliated to Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai City 200032, China. epinephrine@126.com.
Insights
Surgical sealant significantly reduced postoperative bleeding and transfusion needs in patients undergoing Bentall procedures. This intraoperative technique improved outcomes without increasing adverse events or intensive care unit stay.
Area of Science:
- Cardiovascular Surgery
- Surgical Innovation
- Hemostasis Management
Background:
- Postoperative bleeding is a significant risk in cardiovascular surgery, increasing morbidity and mortality.
- Intraoperative techniques are crucial for mitigating bleeding risks.
- The Bentall procedure carries a substantial risk of bleeding complications.
Purpose of the Study:
- To evaluate postoperative bleeding parameters after Bentall procedures.
- To assess the impact of intraoperative surgical sealant application on bleeding outcomes.
Main Methods:
- Retrospective analysis of 100 consecutive Bentall procedure cases.
- Comparison of bleeding-related outcomes between patients who received surgical sealant and those who did not.
Main Results:
- Surgical sealant use was associated with significantly less drainage, fewer resternotomies for hemorrhage, and reduced transfusion requirements (red blood cells and fresh frozen plasma).
- Patients receiving surgical sealant had longer cardiopulmonary bypass and aortic cross-clamp times, but no significant difference in intubation or ICU duration.
- Excluding urgent cases or Stanford type A dissections, ICU duration was significantly shorter in the surgical sealant group.
- No adverse events were associated with surgical sealant use.
Conclusions:
- Surgical sealant application on anastomosis suture lines in Bentall procedures effectively reduces postoperative bleeding and transfusion needs.
- Further investigation through prospective, randomized clinical trials is recommended to confirm these findings.
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.
