Sealing of highly porous fabric vascular prostheses by adipose connective tissue fragments instead of preclotting with fresh blood.
Preclotting is an essential procedure for porous fabric vascular prostheses, but fatal bleeding due to fibrinolysis after implantation can occur in some cases. To overcome this problem, a method was developed to seal highly porous fabric vascular prostheses with adipose connective tissue fragments. A piece of subcutaneous adipose connective tissue weighing approximately 1 g was minced with scissors and stirred into 20 mL of saline, thereby creating a tissue suspension. This was sieved through the wall of a highly porous fabric prosthesis from the outside to the inside by intraluminal suction. The prostheses were implanted in the thoracic descending aortae of 20 dogs and removed from 1 h to 1 year after implantation. Twelve preclotted prostheses were used as controls. None of the the treated grafts experienced bleeding complications postoperatively. In the controls, the chest wall was closed after the bleeding stopped from the suture line and through the prosthesis wall, but problems occurred after surgery. Three out of 12 control animals (25%) bled in the pleural cavity within 24 h. In the tissue-sealed grafts, smooth neointima formation without any degenerative changes was observed during a 1-year observation period.
First Department of Surgery, Yokohama City University School of Medicine, Japan.
Y
Y
Noishiki
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Y
Yamane
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Y
Tomizawa
D000273:Adipose Tissue / Q000502:physiology*; D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D001807:Blood Vessel Prosthesis / Q000295:instrumentation*; D004285:Dogs; D005260:Female; D008297:Male; D011093:Polyethylene Terephthalates; D016062:Porosity; D013997:Time Factors; D014014:Tissue Adhesives
D011093:Polyethylene Terephthalates; D014014:Tissue Adhesives