Does the additional usage of a local hemostatic patch reduce bleeding after aortic reimplantation?

Area of Science:

• Cardiovascular Surgery
• Hemostasis
• Surgical Innovation

Background:

• Aortotomy suture line bleeding is a common complication in aortic valve replacement.
• Effective local hemostasis is crucial for minimizing blood loss and improving patient outcomes.
• Human thrombin and fibrinogen-based hemostatic agents offer a potential solution for controlling surgical bleeding.

Purpose of the Study:

• To evaluate the efficacy of a local hemostatic patch (Tachosil) in reducing bleeding after aortic valve replacement.
• To assess the impact of Tachosil on postoperative drainage, blood loss, and related complications.
• To determine the safety and effectiveness of Tachosil in a randomized controlled trial.

Main Methods:

• A randomized controlled trial involving 93 patients undergoing elective aortic valve replacement.
• Patients were assigned to either a control group (no hemostatic patch) or an intervention group (Tachosil patch applied to aortotomy suture line).
• Primary outcome measures included postoperative drainage volume and secondary outcomes such as rethoracotomies, hemoglobin levels, and renal complications.

Main Results:

• Significantly lower postoperative drainage was observed in the Tachosil group compared to the control group (p = 0.0335).
• Tachosil-treated patients exhibited significantly higher hemoglobin concentrations (p < 0.001, p = 0.0002) and red blood cell counts.
• While rethoracotomy rates were higher in the control group, the difference was not statistically significant. Renal complications and infection rates showed no significant difference between groups.

Conclusions:

• The application of Tachosil on the aortotomy suture line effectively reduced postoperative drainage after aortic valve replacement.
• Reduced drainage associated with Tachosil use positively influenced renal complication rates.
• Tachosil represents a valuable adjunct for achieving hemostasis in cardiac surgery, potentially improving patient recovery.