Ueda T, Shimizu H, Hachiya T, Ito T, Goto T, Mitsumaru A, Katogi T, Yozu R, Kawada S
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Oct;42(10):1904-9.
We used gelatin-resorcin-form-aldehyde (GRF) glue to fuse the false lumen of type A acute aortic dissection in four patients. All were operated on within 3-24 hours after onset, and gluing of the two cylinders of the dissecting aorta could be done safely in a short time. Initial intimal tears were located in the transverse aorta in three patients and in the proximal descending aorta in one. Simple transection and end-to-end anastomosis of the ascending aorta was done for the first two cases. But in the last two patients, we resected the intimal tear in the transverse aorta and applied GRF glue to the stump of the aortic arch and to that of the aortic root, followed by graft replacement of the ascending aorta. There were no hospital deaths. But we had to reoperate on one patient five months after the first operation due to potentially residual dissection in the aortic root. GRF glue is a very useful adhesive for acute aortic dissection operations, but further refinement of the operative technique using it is necessary.
我们使用明胶-间苯二酚-甲醛（GRF）胶水对4例A型急性主动脉夹层患者的假腔进行融合。所有患者均在发病后3至24小时内接受手术，在短时间内可以安全地完成对夹层主动脉两个管腔的粘合。3例患者的初始内膜撕裂位于横主动脉，1例位于降主动脉近端。前两例患者行升主动脉简单横断并端端吻合。但在后两例患者中，我们切除了横主动脉的内膜撕裂，将GRF胶水应用于主动脉弓残端和主动脉根残端，随后行升主动脉人工血管置换。无住院死亡病例。但有1例患者在首次手术后5个月因主动脉根部可能存在残余夹层而再次手术。GRF胶水对于急性主动脉夹层手术是一种非常有用的粘合剂，但有必要进一步完善使用它的手术技术。
