Hemostatic effectiveness of a new application method for fibrin glue, the "rub-and-spray method", in emergency aortic surgery for acute aortic dissection

This study was performed to evaluate the clinical hemostatic effectiveness of a new application method for fibrin glue, the rub-and-spray method, in aortic surgery. Twenty consecutive patients undergoing emergency ascending aorta or ascending-hemiarch replacement for Stanford type A acute aortic dissection were prospectively randomized into 2 groups, one with the rub-and-spray method (group G, 10 patients) and one without fibrin glue (group C, 10 patients). The rub-and-spray method consists of using a finger to rub the fibrinogen solution over needle holes, then spraying the fibrinogen solution and the thrombin solution simultaneously over the anastomosis, using an application nozzle. The number of bleeding needle holes at the proximal and distal anastomoses just after reperfusion, the hemostatic period (time from administration of protamine sulfate until closure of the pericardium), and the amounts of blood losses during this hemostatic period were measured. The values in group G and group C were as follows: proximal needle holes (26.8 +/- 1.5, 26.4 +/- 2.4, p = 0.466); proximal bleeding needle holes (0.2 +/- 0.4, 19.3 +/- 3.5, p