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The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 867-877, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Nojiri, Y Noishiki and H Koyanagi
At present, only the autogenous saphenous vein is acceptable in aorta-
coronary bypass grafting. We developed a small-caliber vascular graft and
evaluated the potential application for aorta-coronary bypass grafting.
Canine carotid arteries were cross-linked with polyepoxy compounds, such as
polyglycerol polyglycidyl ether, which is a new cross-linking reagent, and
then heparinized by our own method. The polyepoxy compound-cross-linked
graft can keep the natural vessel compliance and is stronger than the
glutaraldehyde-cross-linked graft; thus, it provides excellent suturability
and compliance match. Heparin was gradually released from the graft wall,
and thrombus formation was completely prevented during the period before
development of the endothelial lining. As a pilot study, the grafts, 2 to 3
mm in internal diameter and 5 to 7 cm in length, were evaluated as
bilateral carotid replacements in five dogs. All grafts were patent at
intervals of 14 to 177 days. Histologic examinations showed excellent
antithrombogenic and healing characteristics, although the
endothelialization was delayed by heparin, which inhibits cell adhesion and
fibrin deposition. The 3 mm internal diameter graft was evaluated as an
aorta-coronary bypass grafting model in eight dogs. Flow within grafts to
the right coronary artery ranged from 25 to 35 ml/min, and flow in the
circumflex or left anterior descending grafts ranged from 75 to 100 ml/min.
Cineangiography was performed to confirm graft patency. Three dogs died of
viral infection and one was killed. At necropsy, the grafts remained patent
without thrombi along the graft length. Four dogs were allowed to survive
for long-term evaluation. All grafts were patent at time intervals to 21 to
113 days with 100% patency. These results led us to conclude that our newly
developed small-caliber vascular graft shows great promise in application
for aorta-coronary bypass grafting.
ARTICLES
Aorta-coronary bypass grafting with heparinized vascular grafts in dogs. A preliminary study
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