Dissected Aortic Sinuses Repaired with Gelatin-Resorcin-Formaldehyde (GRF) Glue are not Stable on Follow Up
Ulrich O. von Oppell MD, Zeead Karani MD, Andre Brooks MD, Johan Brink MD

This study was a retrospective review of patients operated on for ascending aortic dissections. The aortic valve was resuspended and the proximal aortic sinuses glued with gelatin-resorcin-formaldehyde (GRF) glue in 19 patients. Late recurrent aortic regurgitation occurred in 64% of operative survivors. No recurrent aortic valve or aortic root disease occurred in nine acute dissection patients in whom the aortic valve was either not dissected or replaced (p <0.05), or in the 13 chronic dissection patients treated (p <0.01). Actuarial survival of patients in whom the aortic valve was resuspended and GRF glue used was 52.1 ± 11.6% at five years and 27.8 ± 14.3% at eight years, compared with 55.6 ± 16.6% at five years if the aortic valve was not resuspended. GRF gluing of acute dissected aortic sinuses combined with aortic valve resuspension is associated with a high incidence of recurrence of proximal aortic disease. It is suggested that all acute dissected aortic sinus tissue be resected.