Primary vascular anastomosis in growing pigs. Comparison of polypropylene and polyglycolic acid sutures

Walter Pae, J. A. Waldhausen, G. A. Prophet, W. S. Pierce

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Stenosis remains a significant problem in vascular anastomoses performed in the growing patient. This study compares the growth of vascular anastomoses performed with either polypropylene or polyglycolic acid sutures. End-to-end infrarenal aortic anastomoses were performed in 18 piglets. Twelve were performed with polypropylene; in six all sutures were placed in a continuous fashion (Group 1A), and in the other six the posterior sutures were continuous and the anterior were interrupted (Group 1B). Six anastomoses were performed with polyglycolic acid sutures placed in a continuous fashion (Group 2). The animals were killed 6 months following operation. The abdominal aorta was removed, measured, burst tested, and subjected to histologic studies. All anastomoses were patent. There were no burst failures at 300 mm Hg mean pressure. All polypropylene sutures in Group 1A and the continuous portion in Group 1B had straightened without breaking. Straightening without polypropylene suture breakage resulted in stricture in three Group 1A anastomoses and one Group 1B anastomosis; there was intraluminal polypropylene suture material in two Group 1A and five Group 1B anastomoses. Bowstring formation of the straightened, continuous portion of the polypropylene suture in two Group 1A anastomoses and one Group 1B anastomosis resulted in adherent thrombus. Group 2 anastomoses were without stricture and were grossly indistinguishable from adjacent normal vessel. Histologic examination showed varying degrees of chronic inflammation in the polypropylene anastomoses but negligible inflammation in the polyglycolic acid anastomoses. These results suggest that continuous suture techniques with polypropylene in growing vessels may result in stenosis and/or thrombosis. Moreover, synthetic absorbable polyglycolic acid sutures will be of use in vascular anastomoses in growing patients and in cases in which exacting technique with minimal postsurgical inflammation may be crucial to patency.

Original languageEnglish (US)
Pages (from-to)921-927
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume81
Issue number6
StatePublished - Jan 1 1981

Fingerprint

Polyglycolic Acid
Polypropylenes
Sutures
Blood Vessels
Swine
Pathologic Constriction
Inflammation
Thrombosis
Suture Techniques
Abdominal Aorta
Pressure

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "Stenosis remains a significant problem in vascular anastomoses performed in the growing patient. This study compares the growth of vascular anastomoses performed with either polypropylene or polyglycolic acid sutures. End-to-end infrarenal aortic anastomoses were performed in 18 piglets. Twelve were performed with polypropylene; in six all sutures were placed in a continuous fashion (Group 1A), and in the other six the posterior sutures were continuous and the anterior were interrupted (Group 1B). Six anastomoses were performed with polyglycolic acid sutures placed in a continuous fashion (Group 2). The animals were killed 6 months following operation. The abdominal aorta was removed, measured, burst tested, and subjected to histologic studies. All anastomoses were patent. There were no burst failures at 300 mm Hg mean pressure. All polypropylene sutures in Group 1A and the continuous portion in Group 1B had straightened without breaking. Straightening without polypropylene suture breakage resulted in stricture in three Group 1A anastomoses and one Group 1B anastomosis; there was intraluminal polypropylene suture material in two Group 1A and five Group 1B anastomoses. Bowstring formation of the straightened, continuous portion of the polypropylene suture in two Group 1A anastomoses and one Group 1B anastomosis resulted in adherent thrombus. Group 2 anastomoses were without stricture and were grossly indistinguishable from adjacent normal vessel. Histologic examination showed varying degrees of chronic inflammation in the polypropylene anastomoses but negligible inflammation in the polyglycolic acid anastomoses. These results suggest that continuous suture techniques with polypropylene in growing vessels may result in stenosis and/or thrombosis. Moreover, synthetic absorbable polyglycolic acid sutures will be of use in vascular anastomoses in growing patients and in cases in which exacting technique with minimal postsurgical inflammation may be crucial to patency.",
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Primary vascular anastomosis in growing pigs. Comparison of polypropylene and polyglycolic acid sutures. / Pae, Walter; Waldhausen, J. A.; Prophet, G. A.; Pierce, W. S.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 81, No. 6, 01.01.1981, p. 921-927.

Research output: Contribution to journalArticle

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