急性大動脈解離手術時に使用したGRF糊が原因と考えられる遠隔期基部大動脈仮性瘤の一例

概要

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It has recently been reported that tissue toxicity from formaldehyde can cause a false aneurysm around the aortic root in cases where GRF glue has been used. A residual ascending aorta in a 55-year-old male became a very large false aneurysm during follow up after an acute type A aortic dissection. At the initial operation, the ascending aorta had been replaced with a prosthetic graft and the anastomosis site repaired using gelatin resorcinol formaldehyde (GRF) glue. During the operation, necrosis of the arterial wall was recognized around the proximal anastomosis site between the graft and the native aorta wall. Because of severe adhesion around the native aortic tissue and the left main coronary artery the patient required an aorto-coronary bypass graft and an additional patch reconstruction of the pulmonary artery. Though the operation was very invasive because of the long cardiopulmonary bypass and anoxic arrest, the postoperative course was uneventful. This report highlighted that careful follow up of a false aneurysm formation around an aortic root is needed in cases where GRF glue is used in the initial operation. Surgeons need to be aware of the distinctive complications possible in re-do operations around an aortic root, and take steps to prevent such occurrences.
自治医科大学の論文
2007-12-01