Bachet J, Gigou F, Laurian C, Bical O, Goudot B, Dubois C, Brodaty D, Guilmet D
Arch Mal Coeur Vaiss. 1983 Jan;76(1):87-94.
The gelatine-resorcine-formol glue (GRF) was used to reinforce the tissues of 25 patients operated for acute dissection of the ascending aorta, between January 1977 and September 1980. The results were compared with those of a control group of 25 patients operated between 1970 and 1976 by "classical techniques". There were no significant differences between the two groups as regards age, anatomical and preoperative clinical states. The ascending aorta was replaced in all patients; the aortic valve was replaced three times (12 p. 100) in the GRF group and twelve times (48 p. 100) in the control group: the coronary arteries were bypassed or reimplanted in 20 p. 100 of patients in both groups. The average peroperative blood loss was 5,800 ml in the control group and 2,100 ml in the GRF group (p less than 0,01). There were four peroperative deaths (16 p. 100) in the control group and no peroperative deaths in the GRF group. Postoperative complications (renal failure, cerebral ischemia, persistent peripheral ischemia or infection) were much more common in the control group. They were responsible for eight hospital deaths in the control group and two hospital deaths in the GRF group (p less than 0,01). Therefore, global hospital mortality was reduced from 48 p. 100 (control group) to 8 p. 100 (GRF group) (p less than 0,01). Two late deaths occurred in the control group, but there were none in the GRF one, all survivors being in good clinical condition. Sixteen patients in the GRF group underwent 19 angiographic controls, 2 to 36 months after surgery. These investigations showed two moderate aortic regurgitations (8 p. 100), three persistent dissections of the descending aorta but a stable, good quality repair in the other patients. In conclusion, the use of GRF glue significantly reduced: 1) the number of aortic valve replacements, 2) per- and postoperative blood loss, 3) the incidence and severity of postoperative complications. The long-term survival rate (4 years) has improved from 40 to 91 p. 100.
1977年1月至1980年9月期间，使用明胶 - 间苯二酚 - 甲醛胶（GRF）对25例接受升主动脉急性夹层手术的患者组织进行加固。将结果与1970年至1976年间采用“传统技术”手术的25例患者的对照组结果进行比较。两组在年龄、解剖结构和术前临床状态方面无显著差异。所有患者均进行了升主动脉置换；GRF组主动脉瓣置换3例（12%），对照组12例（48%）；两组均有20%的患者进行了冠状动脉搭桥或再植入。对照组术中平均失血量为5800毫升，GRF组为2100毫升（p<0.01）。对照组有4例术中死亡（16%），GRF组无术中死亡。对照组术后并发症（肾衰竭、脑缺血、持续性外周缺血或感染）更为常见。对照组有8例医院死亡，GRF组有2例医院死亡（p<0.01）。因此，总体医院死亡率从48%（对照组）降至8%（GRF组）（p<0.01）。对照组发生2例晚期死亡，GRF组无晚期死亡，所有幸存者临床状况良好。GRF组16例患者在术后2至36个月接受了19次血管造影检查。这些检查显示有2例中度主动脉瓣反流（8%），3例降主动脉持续性夹层，但其他患者修复稳定、质量良好。总之，使用GRF胶显著减少了：1）主动脉瓣置换的数量；2）术中和术后失血量；3）术后并发症的发生率和严重程度。长期生存率（4年）从40%提高到了91%。
