Key result
Two patients developed proximal anastomotic pseudoaneurysms 18 and 24 months after emergent aortic replacement for type A acute aortic dissection using BioGlue, with pathology showing tissue necrosis.
Case Report (n=2)
No
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The use of BioGlue during emergent aortic replacement for Type A dissection may cause tissue degeneration leading to late proximal anastomotic pseudoaneurysms, necessitating strict long-term follow-up.
A型急性大動脈解離に対する人工血管置換後遠隔期に，BioGlueによる組織変性が原因として疑われた吻合部仮性動脈瘤を生じた2例を経験した．症例1：66歳，男性．A型急性大動脈解離に対して緊急上行弓部置換術施行．術1年8カ月後に胸痛を認め，CTで中枢側吻合部仮性動脈瘤と診断，再上行置換術を行った．症例2：78歳，女性．A型急性大動脈解離に対して緊急上行置換術施行．術2年後にCTで中枢側吻合部仮性動脈瘤と診断，再上行置換術を行った．両症例とも初回手術時，BioGlueを偽腔に注入し断端形成が行われていた．病理学的所見では，大動脈壁全層にわたって平滑筋細胞の核消失・壊死所見を認めた．BioGlueを使用した症例では，遠隔期に吻合部仮性動脈瘤を来す可能性があり，適正な使用方法の遵守及び，長期にわたる厳格な経過観察が必要である．
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Otaka et al. (2023) conducted a case report in Stanford Type A Acute Aortic Dissection (n=2). BioGlue was evaluated on Development of proximal anastomotic pseudoaneurysm. Two patients developed proximal anastomotic pseudoaneurysms 18 and 24 months after emergent aortic replacement for type A acute aortic dissection using BioGlue, with pathology showing tissue necrosis.
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