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Autologous fibrin sealant application in cardiac surgery - a single-centre observational study
Radosław Jarząbek1, Krzysztof Greberski2, Paweł Bugajski2
1Department of Cardiac Surgery, J. Struś Municipal Hospital, Poznan, Poland.
Insights
Autologous fibrin glue is a safe option for sealing suture lines in cardiovascular surgery, potentially reducing the need for other hemostatic agents. This method offers an alternative to traditional sealants without increasing complications or mortality.
Area of Science:
- Cardiovascular Surgery
- Surgical Hemostasis
- Biomaterials
Background:
- Minimizing blood loss and post-transfusion complications is crucial in cardiovascular surgery.
- Various strategies are employed to achieve hemostasis during these procedures.
Purpose of the Study:
- To evaluate the efficacy of intraoperative autologous fibrin glue for sealing suture lines in cardiac and vascular procedures.
- To compare outcomes between patients receiving autologous fibrin glue and those receiving standard hemostatic agents.
Main Methods:
- A comparative study of 62 patients undergoing complex cardiac surgery under extracorporeal circulation.
- The study group received autologous fibrin sealant (Vivostat) alongside routine hemostatic agents.
- The control group received only standard hemostatic agents; outcomes included drainage and blood product usage.
Main Results:
- No significant differences in mean patient age or comorbidities between groups.
- Fewer standard hemostatic agents were used in the autologous fibrin glue group (e.g., Preveleak tissue glue in 3.2% vs. 33.3%, p=0.008).
- Postoperative drainage, blood product transfusion, in-hospital mortality, and complication rates were similar between groups.
Conclusions:
- Autologous fibrin glue is a safe hemostatic agent in cardiovascular surgery.
- Its application may reduce the reliance on conventional hemostatic agents.
- It presents a viable alternative to existing local hemostatics, avoiding infection and immune response risks.
Introduction:
To minimize the risk of blood loss and post-transfusion complications in patients undergoing cardiovascular surgery, different strategies are used.
Aim:
To analyse the efficacy of the intraoperative use of autologous fibrin glue to seal suture lines of cardiac and vascular structures.
Material And Methods:
The early results of 62 patients who underwent complex cardiac operations in extracorporeal circulation were analysed. In a half of them Vivostat autologous fibrin sealant in addition to the routine haemostatic agents was applied (study group), whereas in the second group (matched-pair control group) only standard haemostatics were used. Among many other factors, special attention was paid to postoperative drainage and blood products used.
Results:
The mean age of the patients and prevalence of comorbidities did not differ between groups. Generally, in the study group fewer haemostatic agents were used. For example, Preveleak tissue glue was applied in 3.2% of studied cases compared to one third of control patients (p = 0.008). The thoracic drainage on either day 0 or day 1 was also similar. The number of patients who received blood products did not differ between groups. More importantly, there were no significant differences in in-hospital mortality and prevalence of other postoperative complications.
Conclusions:
In this study it was found that application of autologous fibrin glue was safe and might limit use of standard haemostatic agents. Taking into account the lack of potential threats related to the transmission of infections and immune responses, it may be an interesting alternative to the previously used local haemostatics.
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