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Sutureless patch repair of post-myocardial infarction left ventricular rupture.

Ventricular rupture following myocardial infarction is a serious clinical problem with a high mortality. A 60-year-old man with left ventricular rupture and cardiac tamponade following myocardial infarction was managed successfully by emergency surgery. An onlay patch of Teflon held in place by an adhesive without any sutures was used to repair the ruptured myocardium.

Cardiac Pacing, Artificial↗
PubMed2004

Robot-assisted sutureless minimally invasive mitral valve repair.

Our institution has performed over 100 robot-assisted mitral valve repairs. The procedure has shown many advantages to conventional sternotomy-based repair. However, the robotic approach leads to longer cross-clamp and bypass times than conventional sternotomy. As a result of the increased risk of myocardial damage and arrhythmias from lengthy arrest times, nitinol U-clips have been used in the laboratory and currently in patients for the tissue-annuloplasty ring approximation. The technology replaces the time-consuming task of knot tying, as well as provides better visualization during placement of the annuloplasty ring. The animal studies show excellent tissue incorporation. Short-term echocardiographic imaging shows durability without evidence of mitral stenosis or regurgitation. Further studies are ongoing in our patient population, and the data suggest shorter, more efficient and effective robot-assisted mitral valve repairs.

Cardiac Surgical Procedures↗
PubMed1991

[Biological glue and obstruction of bronchial stumps. Experimental study. Sutureless bronchial closure of lobectomies in dogs].

From April, 1989 to January, 1990, we have been "inducing bronchial fistulae" in dogs by performing 10 lobectomies, 5 middle and 5 caudal, in both the right and the left lung. The bronchial stump was not sutured but closed by a "Tissucol-vicryl mesk" implant, which can be adapted to the size of the stump and is fully absorbed in the long term and replaced by a natural fibrous plug. The results seem to be fairly satisfactory: no dog died; all stumps--followed up a D10, D12... up to the 11th month--were obturated without complications, at least in these animals whose bronchi were normal and not infected. Bronchial fistulae still are a serious complication of lung resections, and while the smaller fistulae (2-3 mm) can be managed with biological glue delivered by simple endoscopy, severe fistulae--especially after pneumonectomy, above all in the right lung--often demand difficult, high-risk surgery. This points out to the interest of this small experimental series. Two conditions are essential to successfully implement this alternative procedure: 1) perfect sterilization of the excision pocket; a window is often required, which in addition has the advantage of facilitating the insertion and observation of the implant; 2) a high concentration of aprotinin (10,000 units) delaying the dissolution of the glue plug, thus allowing it to be integrated by the natural healing process.

Adhesives↗