title: Pretreatment of synthetic vascular grafts with heparin before implantation, a simple technique to reduce the risk of thrombosis.
abstract: Thrombosis of synthetic grafts commonly used in cardiovascular surgery is a major complication. We examined whether pretreatment of the graft with heparin reduces the risk of early thrombosis. A circuit was assembled to compare two pairs of shunts simultaneously in the same animal. The study shunts were pretreated with heparin. After 2 hours of circulation, clot formation was evaluated by image analysis techniques. The pretreated grafts had fewer blood clots adhered to the surface by direct visual inspection. The image analysis showed 5 vs. 39 clots, 0.01% vs. 1.8% clotted area, and 62 vs. 5630 clot pixel area between the treated and non-treated grafts respectively, p < 0.05. Pretreatment of the synthetic graft with heparin prior to implantation reduces the risk of early clot formation. This simple practice might be helpful to prevent initial thrombosis of the graft and later occlusion.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA rgerrah@gmail.com.
authors.forename: Rabin
authors.initials: R
authors.lastname: Gerrah
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Sunstrom Pa-C
authors.affiliation: Division of Maternal/Fetal Medicine, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Hohimer
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D001777:Blood Coagulation; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006439:Hemodynamics; D006493:Heparin / Q000008:administration & dosage*; D023421:Models, Animal; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012307:Risk Factors; D013552:Swine; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene; D006493:Heparin
keywords: Heparin; aortopulmonary shunt; polytetrafluoroethylene; synthetic graft; thrombosis