Case reportClosure of bronchopleural fistulas using Albumin-Glutaraldehyde tissue adhesive
Section snippets
Patient 1
A 21-year-old woman underwent a right pneumonectomy for a carcinoid tumor involving the right mainstem bronchus, which was transected just above the origin of the upper lobe. One-month later, she developed an empyema and underwent tube thoracostomy. Bronchoscopy revealed a large fistula at the medial aspect of the bronchial stump. Although the air leak initially subsided with the application of fibrin, it recurred the following day. On final pathology, the pneumonectomy margin was positive for
Comment
Bronchopleural fistulas occur in 0.8% to 15% of patients after pneumonectomy [2] and can have devastating consequences including aspiration pneumonia and empyema with a mortality between 29% and 71% [1]. Factors that predispose to fistula formation include chemotherapy or radiation therapy, positive margins, a long bronchial stump, right pneumonectomy, and postoperative mechanical ventilation 1, 2. Excessive dissection, resulting in tissue ischemia, and tension on the bronchial suture line can
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2018, Acta BiomaterialiaCitation Excerpt :Additionally, BioGlue is a commercialized glutaraldehyde-based formulation with a similar gluing mechanism to GRF/GRFG, whose indicated applications were restricted as adjunct for enhancing standard hemostasis (such as sutures and staples) at vascular anastomoses in open surgical repairs [46,153,154]. In addition to the potential toxicity caused by formaldehyde, studies have shown the albumin-glutaraldehyde bioadhesives have a slower in vivo degradation rate than GRF/GRFG; this may cause collagen remodeling disorder and even hinder wound healing [155,156]. In the following sections, internal bioadhesives based on different adhesive and cohesive mechanisms are discussed.
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2018, Respiratory MedicineCitation Excerpt :Given their expertise in positioning and deploying these devices, collaboration with interventional cardiology is recommended. BioGlue is derived from bovine albumin cross-linked by glutaraldehyde and has been approved as an adhesive for vascular anastomoses [34]. The components are mixed in a double helix syringe, and polymerization begins immediately upon application.
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