Postoperative Aortic Regurgitation Probably due to Use of Gelatin-Resorcin-Formalin Glue for Acute Aortic Dissection / 日本心臓血管外科学会雑誌

ABSTRACT

A 45-year-old man presented with cough and dyspnea. He had undergone reconstruction of the ascending aorta for acute aortic dissection (DeBakey type I) 5 months previously, at which time we used the gelatin-resorcin-formalin glue (GRF glue) for reconstruction of the wall layer. Preoperative transesophageal echocardiography and aortography revealed aortic regurgitation due to redissection of the aortic root. Intraoperatively, dehiscence was noted between the right coronary sinus including the coronary ostia and the non-coronary sinus. These intraoperative findings suggested that the pathology leading to the redissection was related to the previous use of GRF glue. The redissected segment appeared to be necrotic on macroscopic examination intraoperatively, however histological examination revealed only degenerative changes, and there was no evidence of the glue. He was treated by the modified Bentall method and had a good postoperative course after discharge. In this case, it is also conceivable that tissue necrosis resulted from the use of too much formalin.