Mechanical Properties of Surgical Glues Used in Aortic Root Replacement
Mechanical Properties of Surgical Glues Used in Aortic Root Replacement
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DOI：
10.1016/j.athoracsur.2008.12.072
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发表时间：
2009-04-01
影响因子：
4.6
通讯作者：
Tseng, Elaine E.
中科院分区：
文献类型：
--
作者：
Azadani, Ali N.;Matthews, Peter B.;Tseng, Elaine E.
背景外科胶水用于机械、无支架生物假体和同种主动脉根置换术，以密封和加强吻合缝合线。主动脉根通常会经历实质性的生理扩张，并可能受到所用密封剂硬度的影响。我们确定了四种常见的商业胶水的材料特性，将其与已知的主动脉根部扩张的特性进行比较。对BioGlue（CryoLife，Inc，肯尼索，GA）、CoSeal（巴克斯特国际医疗保健公司，Palo Alto，CA）、Tisseel（巴克斯特医疗保健公司，Glendale，CA）和Crosseal（OMRIX Biopharmaceuticals，Inc，纽约，NY）密封剂样品进行双轴拉伸试验。Hookean应变能函数拟合每个样品的应力-应变响应，并获得杨氏模量用于比较材料刚度。密封剂表现出对载荷的相对线性响应; BioGlue（3，122.04 +/-1，639.68 kPa）、CoSeal（100.02 +/- 67.60 kPa）、Tisseel（102.59 +/- 41.13 kPa）和Crosseal（53.56 +/- 32.59 kPa）的平均弹性模量变化很大。CoSeal和Tisseel的刚度无显著差异（p = 0.897），而Crosseal的顺应性高于Tisseel（p = 0.004）和CoSeal（p = 0.055）。BioGlue的硬度高于CoSeal、Tisseel和Crosseal（p < 0.001）。此外，BioGlue的硬度远高于Dacron移植物、戊二醛固定的猪根和人主动脉组织。然而，CoSeal和Tisseel的顺应性比主动脉根部吻合器好得多。BioGlue的顺应性远低于其他研究的密封剂和可用于主动脉根部置换的材料。外科医生选择的胶水应根据硬度和密封剂的有效性来确定。刚度大于主动脉根部置换材料的密封剂可能会限制正常的生理扩张并导致吻合口狭窄。
Background. Surgical glues are used in mechanical, stentless bioprosthetic, and homograft aortic root replacements to seal and reinforce anastomotic suture lines. The aortic root normally undergoes substantial physiologic dilation and may be affected by the stiffness of applied sealants. We determined the material properties of four common commercial glues, comparing them with known properties of aortic root replacements.Methods. Samples of BioGlue (CryoLife, Inc, Kennesaw, GA), CoSeal (Baxter Healthcare International, Palo Alto, CA), Tisseel (Baxter Healthcare Corp, Glendale, CA), and Crosseal (OMRIX Biopharmaceuticals, Inc, New York, NY) sealants underwent biaxial tensile testing. A Hookean strain energy function was fit to the stress-strain response of each sample, and the Young's modulus was obtained for comparison of material stiffness.Results. Sealants demonstrate a relatively linear response to loading; mean elastic moduli for BioGlue (3,122.04 +/- 1,639.68 kPa), CoSeal (100.02 +/- 67.60 kPa), Tisseel (102.59 +/- 41.13 kPa), and Crosseal (53.56 +/- 32.59 kPa) varied greatly. CoSeal and Tisseel have no significant difference in stiffness (p = 0.897) while Crosseal is more compliant than Tisseel (p = 0.004) and CoSeal (p = 0.055). BioGlue is stiffer than CoSeal, Tisseel, and Crosseal (p < 0.001). Furthermore, BioGlue is much stiffer than cited properties of Dacron grafts, glutaraldehyde-fixed porcine roots, and human aortic tissue. However, CoSeal and Tisseel are much more compliant than the aortic root conduits.Conclusions. BioGlue is much less compliant than the other sealants studied and materials available for aortic root replacement. A surgeon's choice of glue should be determined by stiffness as well as sealant efficacy. Sealants with greater stiffness than aortic root replacement material may restrict normal physiologic dilation and cause anastomotic strictures.