Composite and plain tubular synthetic graft conduits in right ventricle-pulmonary artery position: Fate in growing lambs

Composite and plain tubular synthetic graft conduits in right ventricle-pulmonary artery position: Fate in growing lambs

Our goal was to identify the most appropriate material for right ventricle-pulmonary artery conduits in growing animals. We used 100 lambs that were 3 to 4 weeks old (mean weight 11.7 kg). Follow-up was up to 24 months. Group I received plain tubular conduits: (1) Dacron knitted fabric, (2) collagen...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery Vol. 110; no. 2; pp. 427 - 435
Main Authors: Molina, J.Ernesto, Edwards, Jesse E., Bianco, Richard W., Clack, Rosemarie W., Lang, Gregory, Molina, Jorge R.
Format: Journal Article
Language:English
Published: Philadelphia, PA Mosby, Inc 01-08-1995
AATS/WTSA
Elsevier
Subjects:
Animals
Biological and medical sciences
Blood Vessel Prosthesis
Cardiac Catheterization
Heart Valve Prosthesis
Heart Ventricles - diagnostic imaging
Heart Ventricles - surgery
Medical sciences
Pliability
Polyethylene Terephthalates
Polytetrafluoroethylene
Porosity
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - surgery
Pulmonary Valve - surgery
Radiography
Sheep
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Ventricular Function, Right
Ventricular Pressure
Human
Composition
Treatment
Tube
Root
Surgery
Cardiovascular disease
Replacement
Graft surgical
Pulmonary artery
Comparative study
Result
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Summary:Our goal was to identify the most appropriate material for right ventricle-pulmonary artery conduits in growing animals. We used 100 lambs that were 3 to 4 weeks old (mean weight 11.7 kg). Follow-up was up to 24 months. Group I received plain tubular conduits: (1) Dacron knitted fabric, (2) collagen-coated knitted fabric, (3) Milliknit and Microknit material, (4) woven Dacron fabric, (5) three-dimensional Dacron fabric (crossweave 500 and 800), or (6) polytetrafluoroethylene. Group II received either a (1) woven Dacron fabric conduit with a built-in tissue valve or (2) polytetrafluoroethylene graft with a built-in St. Jude Medical valve. We did angiograms and catheterizations every 3 to 6 months and killed the lambs at 6, 12, 18, or 24 months. Tubular Dacron fabric woven or knitted grafts, regardless of matrix, pore size, thickness, or coating, caused formation of a thick acellular pseudointima buildup, which led to progressive obstruction starting as early as 3 months. Polytetrafluoroethylene grafts in groups I and II showed the formation of thin inner and outer capsules (0.5 mm) and none developed obstruction despite wall calcification. Conduits of woven Dacron fabric with a built-in tissue valve degenerated rapidly, leading to calcification thrombosis and obstruction within 3 months; no lamb survived 12 months. Polytetrafluoroethylene conduits with a St. Jude Medical valve in lambs receiving anticoagulants remained free of obstruction and continued to function well. It appears that synthetic conduits of polytetrafluoroethylene perform well in either of the situations here tested and may be the best choice at present. (J T HORAC C ARDIOVASC S URG 1995;110:427-35)
Bibliography:ObjectType-Article-1
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ISSN:0022-5223
1097-685X
DOI:10.1016/S0022-5223(95)70239-3