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American Journal of Advanced Medical & Surgical Research

Volume 2, Issue 1, 2016
Mcmed International
American Journal of Advanced Medical & Surgical Research
Issn
XXX-XXXX (Print), XXXX-XXXX (Online)
Frequency
bi-annual
Email
editorajamsr@mcmed.us
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Abstract
Title
POLYMERIC SEALANT (COSEAL) IS IT WORTH IN CONGENITAL HEART SURGERY
Author
Amit Mishra
Email
drmishraamit@yahoo.com
keyword
Sealant, Congenital heart surgeries, Post-operative outcome.
Abstract
Our institute being a tertiary referral center in western part of India, we perform nearly 400 neonatal cardiac surgeries every year. The prospective study was designed to look for the effectiveness of the polymeric sealant (CoSeal) in controlling bleeding, and adhesion prevention, in the neonatal congenital heart diseases. From January 2013 to April 2015, 98 patients who underwent various congenital heart disease surgeries were included in the study. The sprayable polymeric matrix - Coseal surgical sealant was electively used in 57 patients (group 1) undergoing arterial switch, norwood and complex neonatal arch repairs. In group 2 no surgical sealant was used and 41 patients from surgeries apart from group 1 were enrolled. The groups were compared for demographic, pre-operative, operative and post-operative characteristics. The results showed better intra- and post-operative outcome in group 1 patients as compare to group 2 patients, which was statistically significant (p<0.05). Amongst operative parameters, mean CPB time (162.67 ± 49.05 vs 182.29 ± 40.84 min) and aortic cross clamp time (125.72 ± 34.8 vs 147.12 ± 58.67 min) were significantly lower in patients were sealant was used. Post-operative complications namely - incidence of leaving the chest open (19.64%), greater days of ventilation (4.43 ± 2.86 days), higher ICU stay duration (10.07 ± 5.8) and hospital stay (14.02 ± 6.12 days) were more prevalent in group 2patients. The use of polymeric sealant has helped us in improving our overall results of congenital surgeries as well as in reducing post-operative morbidity, complications and the overall cost of surgery.
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