Late wound healing problems after use of BioGlue(R) for apical hemostasis during transapical aortic valve implantation

BioGlue (CryoLife Inc, Kenneswa, GA, USA), a bovine serum albumin-glutaraldehyde tissue sealant, was at times used to seal the myocardial holes of the polypropylene stitches at the apex of the heart during transapical aortic valve implantation (TAVI). We describe three patients who developed late wound healing problems after TAVI that were thought to be caused by BioGlue. The surgical wound revision was performed on the 115th, 41st and 60th days, respectively, after original TAVI procedures. At revision, a 'foreign body' reaction surrounded by healthy well-vascularized tissue was found. All intraoperative cultures were sterile despite evidence of purulent-like material at the time of wound debridement. The wounds healed 'per primam intentionem' and the patients' postoperative course was also completely uneventful.