Cardiovascular applications of fibrin sealants and glues

UPDATE: See October 2010 Report #S180, “Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Markets, 2008-2015.

As a follow-up to the recent decision by the FDA to approve Nycomed’s TachoSil absorbable fibrin sealant patch for cardiovascular applications, we wanted to highlight that the cardiovascular arena offers one of the more promising areas for expanded use of surgical sealants and glues.  Cardio applications represent a significant volume of procedures in which the enhanced hemostasis and sealing provided by fibrin sealants can shorten procedure times, improve patient outcomes and, potentially, reduce the cost of procedures.

Specifically, as we identified (in our “Sealants, Glues and Wound Closure Worldwide” Report #S175), the specific procedures with potential impact of fibrin-based or other sealants and glues include the following:

  • Augmentation of aortic and vascular sutures.
  • Repair of minor epicardial lacerations without the use of sutures.
  • Hemostasis and reinforcement of anastomoses of coronary bypass and as an adhesive to optimize and secure the path of coronary bypasses on the heart.
  • Coating of perianeurysmatic tissue in ventricular aneurysm surgery.
  • Reinforcement of sutures and patch adhesion in reduction of the left ventricle.
  • As an adhesive to secure the dissection plane in acute aortic dissections.
  • As a hemostatic agent in the prevention of bleeding of proximal and distal anastomoses in acute aortic dissections.
  • As an adhesive for gluing patches for dissected aorta reinforcement.
  • As a hemostatic agent on anastomoses in aortic valve surgery, particularly in the presence of calcific or atheromatous aortas.
  • Hemostasis and reinforcement of sutures after aortic aneurysm repair.
  • In re-operations, as a hemostatic adhesive on lacerations of the ventricle caused by re-sternotomy or the presence of adhesions.

From a caseload basis, the global potential of sealants/glues in cardiovascular applications breaks down as follows:

Source: Report #S175

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