Fibrin Seal (Tisseel/Tissucol) in Paediatric Cardiothoracic Surgery. The Experience of the Hospital for Sick Children, Great Ormond Street, London

Abstract

Over the last 5 years Tisseel has become an established part of our armamentarium. We have previously reported our preliminary experience and now update those data. Tisseel has been used increasingly for the prophylaxis of haemorrhage control rather than for treatment of established haemorrhage. Since 1980, Tisseel has been utilised in 85 patients with a variety of paedatric cardiac surgical problems, and in 72 of the 85 (85%) excellent haemostasis was achieved. In ten patients (11%) a good result was achieved, and in only three patients (4%) was an unsatisfactory result achieved. One of these was early in our experience, and the remaining two were caused by the application of Tisseel to relatively severe established haemorrhage. Tisseel has also been used to seal serous leak from a Gore-tex graft. In our experience, Tisseel has represented a major advance in the safety of paediatric cardiothoracic surgery and may now be considered an essential part of certain procedures, particularly, for example, the arterial switch and repair of truncus arteriosus.