Case Studies

These case studies are presented only as examples and should not be considered as medical advice for any specific patient.

Emergency CABG Procedure

90% Stenosis of Left Circumflex Artery

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66 Year-Old Female Presents With:

  • Severe coronary artery disease in three vessels including the left coronary artery (Image A) with unstable angina
  • Preoperative anticoagulant/antithrombotic therapy including clopidogrel, heparin and eptifibatide

Operation, Bleeding Complications and Solution:

  • Emergent CABG (x3) using LIMA/saphenous vein grafts
  • Diffuse bleeding along sternal edge upon entry (Image B) and in the mammary bed following dissection of the LIMA (Image C); needle-hole bleeding along vein grafts after reversal of heparin with protamine and placement of sutures (Image D)
  • Intraoperative/postoperative bleeding effectively controlled with the use of fibrin sealant (Images B-D)

Why TISSEEL [Fibrin Sealant]?

  • Clinically proven efficacy in challenging cardiac reoperations1,2
  • Effective in fully heparinized patients undergoing cardiopulmonary bypass1,2
  • Spray application option for even distribution across broad surfaces
  • Pre-filled syringe eliminates mixing and reconstitution

Selected Important Risk Information for TISSEEL [Fibrin Sealant]

  • Do not inject TISSEEL directly into the circulatory system or into highly vascularized tissue; thromboembolic events can occur1
  • Do not use in individuals with a known hypersensitivity to aprotinin1
  • Apply TISSEEL as a thin layer by dripping or spraying using cannula or spray set1
  • Do not use for the treatment of severe or brisk arterial or venous bleeding1
  • Air or gas embolism has occurred when fibrin sealant was administered using pressurized gas. This can occur if a spray device is used at higher than recommended pressures and in close proximity to the tissue surface1