title: In vivo analysis of dynamic tensile stresses at arterial end-to-end anastomoses. Influence of suture-line and graft on anastomotic biomechanics.
abstract: OBJECTIVE
  to determine the influence of an anastomotic suture line and a graft on dynamic tensile stresses of vascular end-to-end anastomoses in vivo.
  
  
  METHODS
  the abdominal aorta of twelve 35-kg pigs was used as an experimental model. Simultaneous recordings of internal arterial diameter and pressure were performed on each pig at 3 successive stages: (1) The genuine artery (REF), (2) artery-artery (A-A) and (3) graft-artery (G-A) anastomosis at 1-mm increments in the immediate perianastomotic area. Thereby, RD (relative distension), CC (compliance coefficient), E(p)(dynamic pressure-strain elastic modulus) and hysteresis loop areas could be calculated for every measuring point.
  
  
  RESULTS
  the graft was significantly stiffer than REF. A-A and G-A anastomoses were significantly less compliant than REF. Maximum E(p), minimum CC and hysteresis loop areas were found at the anastomotic line due to minimum anastomotic RD. Downstream of the G-A anastomosis, the RD, CC, E(p)and loop areas were significantly different from REF, but significantly different from A-A.
  
  
  CONCLUSIONS
  an animal model for acute studies of mechanical properties of vascular end-to-end anastomoses was developed. The main determinant for anastomotic biomechanics was the suture-line itself.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery and Institute of Experimental Clinical Research, Skejby Sygehus, Aarhus University Hospital, Brendstrupgaardsvej, Aarhus N, DK-8200, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Ulrich
authors.forename: N
authors.initials: N
authors.lastname: Staalsen
authors.forename: C B
authors.initials: CB
authors.lastname: Djurhuus
authors.forename: T D
authors.initials: TD
authors.lastname: Christensen
authors.forename: H
authors.initials: H
authors.lastname: Nygaard
authors.forename: J M
authors.initials: JM
authors.lastname: Hasenkam
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001012:Aorta, Abdominal / Q000502:physiology* / Q000601:surgery; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D006439:Hemodynamics; D011140:Polyurethanes; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013552:Swine; D013718:Tensile Strength
chemical_list: D001672:Biocompatible Materials; D011140:Polyurethanes