BioGlue hemostasis of penetrating cardiac wounds in proximity to the left anterior descending coronary artery

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Abstract

BACKGROUND:

Penetrating cardiac injuries necessitate rapid resuscitation and repair, most commonly with the use of pledgeted sutures. Hemostasis can be difficult to obtain with injuries near coronary vessels or with friable tissue that does not hold suture. We describe the use of BioGlue, a synthetic bovine albumin and glutaraldehyde mix, as a hemostatic adjunct in these challenging cases.

METHODS:

Patients sustaining penetrating cardiac injury undergoing emergent operation from January 2000 to January 2010 were reviewed.

RESULTS:

During the 10-year study period, 67 patients required emergent operation for a cardiac injury, with three patients undergoing BioGlue repair of their ventricle. All patients were male with a mean age of 40 years ± 8 years. In two patients, BioGlue was used in addition to suture repair to control hemorrhage, while in one patient BioGlue was used as the only cardiac repair. Hemostasis was achieved in all cases, and there were no cardiac complications in 20 months (range 15–26 months) of follow-up.

CONCLUSIONS:

To our knowledge, this is the first description of the use of BioGlue for repair of penetrating cardiac injuries. This technique should be added to the armamentarium in managing complex cardiac wounds.

LEVEL OF EVIDENCE:

III.

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