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J Thorac Cardiovasc Surg 2004;128:770-771
© 2004 The American Association for Thoracic Surgery
Brief communication |
a Cardiothoracic Unit, University Hospital of Wales, Heath Park, Cardiff, United Kingdom
b Wales Institute of Forensic Medicine, University Hospital of Wales, Heath Park, Cardiff, United Kingdom
Received for publication March 31, 2004; accepted for publication April 6, 2004.
* Address for reprints: Heyman Luckraz, FRCS, Cardiothoracic Unit, Block C5, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, United Kingdom
HeymanLuckraz@aol.com
| The first 20% of the full text of this article appears below. |
Since the experimental work of Koehnlein and Lemperle1 on the use of glue in operations, biologic glues have become part of the armamentarium used in the surgical management of patients undergoing repair of type A aortic dissection, especially where tissues are frail or where added hemostasis is required. It facilitates the reconstruction of the dissected aortic wall layers adjacent to the prosthetic graft. However, the use of tissue glue can be associated with significant risk, namely aortic wall necrosis leading to acute aortic redissection,2 coronary ostial stenosis, cerebral embolism,3 complete heart block, and prosthetic valvular dysfunction. We describe a case in which the glue embolized to the right and left coronary arteries, leading to fatal right ventricular infarction, and also demonstrate the usefulness of postmortem studies with the use of digital technologies for records keeping and educational purposes.
Clinical summary
A 74-year-old woman was referred to our care for emergency repair of type A aortic dissection. The
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