Surgery for acute aortic dissection using gelatin-resorcin-formalin glue: perspective from 10 years of follow-up at a single center

Acute type A aortic dissection is a lethal aortic disease with an extremely poor prognosis unless surgical intervention is performed in a timely manner. Since the clinical introduction of gelatin-resorcin-formalin (GRF) glue in Japan, tear-oriented aortic repairs have been widely performed with the aid of this glue at many institutions over the past decade. A total of 138 patients underwent glue-aided emergency operations for acute type A aortic dissection at Nihon University Itabashi hospital. The hospital mortality rate was 6.7%. The actuarial survival rate was 81.5% after 5 years and 54.8% after 10 years. The rate of freedom from reoperation was 87.9% after 5 years and 72.3% after 10 years. Although application of GRF glue remains controversial because of concerns about the cytotoxicity of formaldehyde and tissue necrosis, cytotoxicity and tissue necrosis have not been found at reoperation. GRF glue demonstrated excellent tissue adhesion and hemostasis capabilities and contributed to improved surgical results. Although some disadvantages have been reported, complications can be avoided by proper use of the glue and proper selection of surgical procedure, based on the pathology of the patient.