Improved growth with bioabsorbable sutures in both high- and low-pressure zones.

Détails

ID Serval
serval:BIB_BC479443DFFA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Improved growth with bioabsorbable sutures in both high- and low-pressure zones.
Périodique
The Annals of thoracic surgery
Auteur⸱e⸱s
von Segesser L.K., Lachat M., Duewell S., Gianom D., Turina M.I.
ISSN
0003-4975
Statut éditorial
Publié
Date de publication
1996
Peer-reviewed
Oui
Volume
62
Numéro
4
Pages
1045-9; discussion 1049-50
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
BACKGROUND: Compromised growth after operation remains a significant problem in the cardiovascular field. Some benefit of absorbable suture materials has been demonstrated for arterial anastomoses. However, for the low-pressure zone, few data are available. METHODS: To assess growth in high- versus low-pressure zones we transected the abdominal aorta (high-pressure zone) as well as the inferior vena cava (low-pressure zone) in 10 young mongrel dogs using for reanastomosis 7-0 nonabsorbable versus absorbable running sutures in random order. RESULTS: All animals survived and were evaluated over 12 months including body weight (gain, 212% +/- 45% for nonabsorbable versus 218% +/- 8% for absorbable; not significant), angiography, and, after elective sacrifice, detailed studies of aorta and vena cava. Systematic complication of angiographic data at 12 months showed at the suture level an area of 13.8 mm2 for nonabsorbable versus 24.3 +/- 14.4 mm2 for absorbable sutures in the high-pressure zone as compared with 12.9 +/- 4.9 mm2 for nonabsorbable versus 25.3 +/- 15.4 mm2 for absorbable sutures in the low-pressure zone. Residual lumen, calculated as a function of the area above and below the suture, accounted for 35% +/- 10% for nonabsorbable versus 92% +/- 12% for absorbable sutures (p < 0.001) in the high-pressure zone as compared with 37% +/- 13% for nonabsorbable versus 75% +/- 15% for absorbable sutures (p < 0.003) in the low-pressure zone (high versus low, not significant). Poststenotic dilatation accounted for 199% +/- 22% for nonabsorbable versus 126% +/- 43% for absorbable sutures (p < 0.01) in the high-pressure zone. In the low-pressure zone, poststenotic dilatation remained below the inflow area, and the residual poststenotic lumen accounted for 52% +/- 14% for nonabsorbable versus 77% +/- 16% for absorbable sutures (p < 0.004). Macroscopic, light, and scanning electron microscopic studies confirmed different growth patterns in high- versus low-pressure zones. CONCLUSIONS: Aortic narrowing resulted in poststenotic dilatation and unrestricted outflow path (hourglass-type stenosis). Caval narrowing was followed by restriction of poststenotic outflow path (funnel-type stenosis). Absorbable suture material allows for superior growth in both high- and low-pressure zones.
Mots-clé
Absorption, Anastomosis, Surgical, Animals, Aorta, Abdominal, Biocompatible Materials, Blood Vessels, Constriction, Pathologic, Dogs, Polymers, Polypropylenes, Pressure, Sutures, Vascular Surgical Procedures, Vena Cava, Inferior
Pubmed
Web of science
Création de la notice
14/02/2008 14:19
Dernière modification de la notice
20/08/2019 15:30
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