Repair of the Swiss-cheese septum using biologic glue
In 1992, Stark and associates developed this technique using fibrin seal of human origin (Tissucal, Immuno-France, Orly, France). Fibrin seal consists of concentrated lyophilized fibrinogen enriched with factor XIII and fibronectin. An aprotinin solution warmed to 37°C was added to the fibrinogen.10 After closing any larger defects either using a pericardial or composite Dacron fabric lined with pericardium, and direct pledget supported sutures, the fibrin seal was injected into a dry operating field. Precautions were taken to avoid too deep an insertion into the left ventricle. Other authors subsequently reported good results with fibrin glue.10,63