Early experience with crimped bovine pericardial conduit for arterial reconstruction.
A bovine pericardial conduit was developed in the laboratory incorporating the principle of crimping used for synthetic vascular prostheses. The pericardium was processed in glutaraldehyde and the tube was crimped by a technique which preserves the integrity of collagen fibres. This vascular substitute presents a non-thrombogenic and non-porous inner surface which does not require preclotting and does not leak. The material is very soft, easy to handle and suture, coapts nicely to suture lines resulting in a hemostatic anastomosis. The crimping design provides longitudinal elasticity and resistance to collapsing, retains its shape with bending and avoids kinking. Crimping provides a circular tube which makes the construction of the anastomosis easier. Experimental studies in dogs demonstrated absence of thromboembolism with the conduit implanted in the abdominal aorta. Fibrin accumulation was not noted in the convexities of the crimps. This conduit was designed for aortic and pulmonary reconstruction and available in different sizes with or without a biological valve. Initial clinical experience included its use in 10 patients with aortic dissections or aortic aneurysms from August 1989 to March 1990. A reconstruction of the abdominal aorta was performed in 2 patients, the descending thoracic aorta in 2, the ascending aorta in 2 and the ascending aorta including the aortic valve and reimplantation of coronary arteries in 4. For the latter 4, composite crimped pericardial tubes containing a porcine bioprosthesis were used. An additional patient with a single ventricle underwent a Fontan type operation also employing a valved crimped pericardial conduit.(ABSTRACT TRUNCATED AT 250 WORDS)
Salles
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CA
Hospital Felicio Rocho, Federal University of Minas Gerais Medical School, Belo Horizonte, M.G. Brazil.
Puig
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LB
Casagrande
I S
IS
Vieira
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GL
Kalil
R A
RA
Souza
L S
LS
Andrade
M A
MA
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D000784:Aortic Dissection / Q000601:surgery*; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D002417:Cattle; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D011474:Prosthesis Design; D051381:Rats